State ‘Baby-Cal’ Health Insurance Program Urged

A new state health insurance program for prenatal and pediatric care--called “Baby-Cal”--was proposed Tuesday as a way of promoting the health of all pregnant women in California and their young children.

The program, outlined in Sacramento by a private health care coalition, would provide insurance for about 60,000 pregnant women and 500,000 children under age 5 who currently have no coverage.

These women and children make up a critical portion of the 5.2 million Californians who have no health insurance of any kind--no private insurance, no Medicare and no Medi-Cal. Nearly 80% of the state’s growing population of medically uninsured people are workers and their children who do not get health insurance through their employers.

In its report, the Health Access coalition called on the state to enact a comprehensive, universal system of affordable health care for all Californians. The adoption of Baby-Cal was urged as a good first step.

“Just as every child must take its first steps, so must California,” the report said. “No arena for action is more compelling than the needs of pregnant women and their young children.”

Assemblyman Burt Margolin (D-Los Angeles) has introduced a bill that would implement Baby-Cal. He estimated the program’s price tag would be about $200 million a year, with about half of it coming from the private sector.

While conceding that the measure faces an “uphill battle,” he said that there is a real chance of getting at least a part of the package approved because of the growing awareness of the cost-effectiveness of providing prenatal care to pregnant women. This care, which is supposed to consist of between 10 and 13 medical checkups beginning early in the pregnancy, has been found to significantly improve birth outcomes. Every $1 spent on prenatal care has been found to save more than $3 in neonatal intensive care expenses that are run up by treating sickly newborns, according to a study by the Institute of Medicine in Washington.

Yet California’s ranking in providing early prenatal care to pregnant women, compared to other states, has fallen from 10th place in 1970 to 32nd in 1985, according to the most recent report of the Southern California Child Health Network.

The latest statistics from the state Department of Health Services show an increase statewide in the number of women delivering babies after receiving late or no prenatal care--up from 24,911 women (5.2%) in 1985 to 26,911 women (5.5%) in 1986.

The Baby-Cal program would target two groups of women and children--those who have no insurance as well as those now insured through the state Medi-Cal program.

Those with no insurance would be helped by a provision that requires employers to give their employees health insurance that specifically covers prenatal care and delivery for pregnant women as well as pediatric care for children under age 5. The employers could provide this coverage either by purchasing private group insurance or by paying the state to provide the coverage through the state’s Baby-Cal program.

The Health Access report recommends that the state set up a new agency to administer Baby-Cal independently of the Medi-Cal program, which has traditionally provided a wide variety of medical services to all people below the poverty level.

John Rodriguez, the state’s top Medi-Cal official in the Department of Health Services, said he was not familiar with the Baby-Cal proposal. But he acknowledged room for improvement in the way Medi-Cal provides prenatal care services. He said that among other things, “there needs to be someone to help the moms through the maze.”