O.C. Puts Off Plan to Aid Uninsured Kids

Lou Correa views children as future leaders, prized possessions in need of protection, especially if their parents can’t afford healthcare. It’s been his cause first as a Democratic assemblyman, and now as an Orange County supervisor.

These days Correa finds himself butting heads with some of his colleagues over health insurance for the county’s estimated 40,000 uninsured children.

Last week, his colleagues turned down -- at least temporarily -- his proposal to spend $2.1 million over the next three years to insure 1,800 children. The program, which would have been funded with mostly federal money, would also have hired 20 outreach workers to link poor children with healthcare programs.

“If we start insuring segments of the population like the poor, then we’ll end up insuring everybody,” Supervisor Jim Silva said.

“Orange County will become a magnet for poor people,” he said.

The Board of Supervisors asked for more information and tabled the plan for a month.

Los Angeles, Riverside and San Bernardino counties, among others in California, provide insurance for some children who can’t get it elsewhere. Orange County has no such program.

The only Democrat on the five-member board, Correa frequently finds himself at odds with his colleagues on social issues.

When Correa first tackled the health issue, he wanted to bring uninsured children to the forefront. But one obstacle his plan encountered was that it meant providing health insurance to children of illegal immigrants. So he deleted them from his proposal.

“I cut out any help to the illegal population,” Correa said. “Given the political climate here in Orange County, I knew it wouldn’t fly.”

Though Correa estimates there are about 40,000 uninsured children in Orange County, a UCLA study in 2003 concluded that 82,000 residents younger than 19 lack medical insurance.

Health experts say many children who do not qualify for Medi-Cal or the state’s Healthy Families low-cost insurance program are illegal immigrants or have parents who earn too much to qualify for the programs but not enough to afford their own health insurance.

At last week’s board meeting, Correa’s scaled-back proposal received a cold reception.

“Here we have a plan where the county spends a third and the feds kick in two-thirds,” Correa said. “That means we invest $2.1 million in county costs over three years and get back $4.7 million from the federal government. To me, that’s a good return.”

But Supervisors Bill Campbell and Silva expressed concern about the county’s lean budget, the potential for county job layoffs next year, and lingering financial effects of the 1994 bankruptcy.

Campbell said the county was not in the business of providing health insurance. “Part of the problem here is that it’s a new social entitlement program.”

It’s not that the county lacks compassion, Campbell said, but that the private health system has stepped forward with initiatives to help the uninsured and that small businesses could do more to provide health insurance for their workers. “It’s not a county responsibility,” he said.

The board’s response frustrated health providers and advocates like Jean Forbath, co-founder of Share Our Selves, a medical clinic and social service provider in Costa Mesa. “It’s indicative of the county’s philosophy for healthcare for many years. It’s very disappointing.”

E. Richard Brown, director of UCLA’s Center for Health Policy Research, said that under Correa’s plan the county would get more than it would pay out. Children would be healthier, do better in school and save schools state funds that would be withheld if they were absent, he said.

“I think the supervisors who are opposing this are missing a number of important benefits,” Brown said.

Larry K. Ainsworth, president and CEO of St. Joseph Hospital in Orange, said a California Kids program started in 1999 among four hospitals in the county by buying $500,000 in insurance premiums to help 1,200 children. The program, which receives mostly private funds, now helps 6,000 children regardless of immigration status, he said.

“But we’re going to need help,” Ainsworth said.

Healthcare professionals know the cost savings when a family has a pediatrician, or another “medical home,” Ainsworth said.

“Mom knows that when Johnny runs a fever, there is a doctor,” he said. “She doesn’t have to go to the emergency room, where costs run seven to 15 [times as much].”

The uncompensated costs for emergency room visits by uninsured patients are often absorbed by hospitals and passed on to the insured in the form of higher deductibles and co-payments, he said.

Correa said he has lost a round but doesn’t intend to give up. He said he wanted to encourage other healthcare professionals to support his proposal before the board.

“What we have is an inefficient health system. Speaking as a father, our children are precious; they’re our future.”