‘Shocking’ Lack Cited in Child Health Insurance

About 90% of California’s 1.6 million uninsured children live in families with at least one working parent, and 65% have parents who work full time, according to UCLA researchers, who called the figures “shocking.”

One in six children in California, and one in four in Los Angeles County, lacks health insurance, the UCLA researchers reported Tuesday.

Their parents, the state’s working poor, often “have to make a choice between food, putting a roof over their child’s head or health insurance,” said E. Richard Brown, a UCLA professor of public health and the study’s senior author.

“It is truly a ‘Sophie’s Choice.’ ”

Many opt for food and rent, he said, putting off doctor visits until their youngsters’ ailments can no longer be ignored. By that time, the care is often more intensive and more expensive, delivered hurriedly in hospital emergency rooms, he said.

Left untreated, common childhood illnesses such as ear infections can result in hearing loss and speech impairment, UCLA researchers said.

Although the nation as a whole has seen a long-term decline in job-based insurance, California’s plight is particularly grim, with a “patchwork of limited coverage,” Brown said. One reason is the state’s heavy concentration of low-paying service and retail jobs, which often do not offer insurance for workers, let alone their dependents, he said.

Only eight states in the country have worse health insurance rates for children, according to Children Now, an advocacy group that joined Brown at a Tuesday news conference at the capital.

Bolstered by the UCLA findings, the consumer group announced that it is sponsoring two bills to expand Medi-Cal eligibility for children, streamline the Medi-Cal application process and improve outreach. A range of other groups, including the California Small Business Assn. and California Medical Assn., is backing the legislative efforts.

Children Now says more than 400,000 children in California are actually eligible for Medi-Cal but for various reasons--including the stigma of welfare and a lack of access and appropriate information--are not on the rolls. Latinos are particularly underrepresented.

All told, Medi-Cal covers about 2.9 million youngsters, accounting for more than half the recipients.

For most of those who are not eligible for the program, the government could provide coverage at a cost of up to $76 per month for every child, Children Now estimates.

One advantage to state spending on Medi-Cal is that it must be matched, almost dollar for dollar, by federal money, the group said.

“The big news for us is not only the size of the problem but the affordability of a solution,” said Lois Salisbury, president of Children Now.

The Wilson administration, which has not taken a position on the two bills, “views these [Children Now and UCLA] reports as very helpful,” said Kathryn Lowell, an assistant secretary at the state Health and Welfare Agency.

But she said that the issues are already on the governor’s agenda and that he has long supported preventive and primary care for children. She cited Wilson’s effort in 1995 to launch a “CaliforniaREACH” program that would have focused on bringing care to youngsters under 6. The bills did not pass.

The administration already has made strides in streamlining Medi-Cal and expanding outreach, she said. It has, for example, reduced enrollment forms from 12 to 3 1/2 pages and eased eligibility screening for pregnant women.

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Uninsured Children

California has a high rate of medically uninsured children compared to other states, largely because of low levels of job-based insurance coverage. The problem is particularly acute in Los Angeles County.

Percentage of children who are uninsured, ages 0-17*

United States: 14%

California: 17%

Los Angeles County: 25%

*

Health insurance coverage of children in Los Angeles County, ages 0-17*

Job-based insurance: 41%

Medi-Cal: 30%

Uninsured: 25%

Other public: 1%

*

Distribution of uninsured children in Los Angeles County by family work status, ages 0-17*

One or both parents of most of the uninsured children are employed.

Part-time employee: 6%

Self-employed: 7%

Nonworking: 9%

Full-time, full-year employee: 65%

Full-time, part-year, employee: 13%

* 1995 Data