O.C. to Focus on Kids’ Lack of Insurance

Orange County public health officials and policymakers will meet today to discuss the growing number of children who lack medical insurance.

Los Angeles, Riverside and San Bernardino counties, among others in California, provide insurance for children who can’t get it elsewhere. But Orange County lacks such a safety net. Only six California counties have a greater percentage of children who are uninsured than Orange County, according to a UCLA Center for Health Policy Research analysis in 2003.

“I want to bring this issue to the forefront and show people what we can do,” said Orange County Supervisor Lou Correa, who organized the 5 p.m. hearing at the county Hall of Administration in Santa Ana. “Children are our most precious possession, and we must protect them.”

Among the ideas expected to be discussed, Correa said, is publicly funded health insurance for children without coverage.

Officials say such a program has been stymied by the financial aftermath of the county’s 1994 bankruptcy and a lack of political will.

Estimates of the number of uninsured children in Orange County vary widely, officials say, in part because they are a generally transient population. Correa estimates there are about 44,000 uninsured children in Orange County; the UCLA data indicate that 82,000 residents younger than 19, or 9.9%, lack medical insurance.

Orange County Health Officer Mark B. Horton said he was hopeful that efforts to insure children would emerge from today’s meeting. “Our goal is to ensure that all children have access to healthcare,” he said.

Children without health insurance may lack vaccines, may fail to take tests to detect serious illness and may not get enough care for chronic illnesses such as asthma, Horton said.

Berta Gomez Garcia, a 36-year-old mother of three, said two of her children had insurance but the third, who gets sick the most, was born in Mexico three years ago and did not qualify for California’s Healthy Families program, which offers insurance to children whose families meet income guidelines.

“He’s had a bunch of ear infections, and each time we feel panic,” Gomez Garcia said. “We have to pay for him, and it can be very expensive.”

Health experts believe that many children who do not qualify for Medi-Cal or the Healthy Families program are either undocumented immigrants or have parents who make too much money to qualify for the programs -- but not enough to buy their own health insurance. Others may not have applied for insurance for which they qualify.

In the absence of public hospitals, many of Orange County’s uninsured rely on 31 nonprofit community clinics that charge on a sliding scale. Most of the clinics are in the central part of the county, but much of the immigrant population has fanned out in recent years to southern areas of the county and lack transportation to the clinics.

For various reasons, “parents just don’t take their children to doctors,” said Isabel Becerra, chief operating officer of the Coalition of Orange County Community Clinics, an umbrella group for the 31 clinics.

“They use home remedies. They’ll go south of the border. We want to have a healthier community. These kids are here, anyway, and they can make everyone sick if they are not treated for what may be a minor problem,” she said.

In Los Angeles County, the Healthy Kids program established in July 2003 provides health insurance to 37,000 residents, no matter their immigration status, younger than 19 who live in the county and are not eligible for other programs. Riverside and San Bernardino counties established a similar program for children in 2002.

Mary Moyer, clinic services manager for the Share Our Selves Free Clinic in Costa Mesa, said Orange County had not made the uninsured a priority because at least until now, it had been a politically unpopular move. The county’s financial crisis created “a good excuse” not to provide for uninsured children, she said.

“I’m outraged that there is not a better safety net,” Moyer said. “I understand there are budget pressures, but we still have one of the worst systems for providing” a net, she said.

Larry K. Ainsworth, president and chief executive of St. Joseph Hospital in Orange, said he hoped the meeting would lead to the allocation of public funds to help uninsured children.

The California Kids Collaborative, comprising the St. Joseph Health Care System and several other health agencies, is paying to insure 6,300 uninsured children this year.

The St. Joseph Health System Foundation and three St. Joseph System hospitals in Orange County will allocate $3 million in the next three years to increase the number of insured to 9,000 and to pay 16 staff members to walk neighborhoods and sign up eligible children for state insurance programs.

“We can do this for three years, but then what? How do these children get health coverage after?” Ainsworth said. “We feel like something has to be done.”

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Gaps among the smallest

Most Southern California counties have a higher percentage of children not covered by health insurance than the statewide rate of 7.7%. More than 10 million people ages 18 and under live in the state.

Children currently uninsured, for selected California counties

*--* % of children # of children # of children County uninsured in county uninsured Los Angeles 8.1% 2,893,000 235,000 Orange 9.9% 823,000 82,000 Riverside 10.6% 528,000 56,000 San Bernardino 9.6% 603,000 58,000 San Diego 11.6% 777,000 90,000

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Source: UCLA Center for Health Policy Research analysis of the 2003 California Health Interview Survey. Graphics reporting by Jennifer Delson