1 in 4 Children in County Lack Health Coverage

An estimated 696,000 children in Los Angeles County--or one in four local youngsters--lack health insurance coverage, according to a report released Tuesday that says most of those uninsured are the children of the working poor.

The result is a major public health challenge that county officials said has them staggered and dismayed.

“A real crisis,” Supervisor Yvonne Brathwaite Burke said.

“A shame and a crime,” Supervisor Zev Yaroslavsky added.

One in five uninsured children had not seen a doctor in a year, the detailed telephone survey of county residents conducted last year found. The study also chronicled language, immigration and transportation obstacles that parents often face in getting youngsters to the doctor.

“The worst part is, there’s no sense of public outrage,” said Dr. Jonathan E. Fielding, the Los Angeles County director of public health. “The public should say, ‘This is not acceptable. We need to do better.’ ”

Even before the survey results were published, officials said Tuesday, they had launched intensified outreach programs to let low-income parents know about low-cost or free insurance programs such as Medicaid, the government-subsidized insurance plan that is known as Medi-Cal in California. Officials hope those programs will relieve overcrowding at county emergency rooms, often used by poor families without insurance.

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Since February, the county’s Department of Public Social Services has been open evenings and weekends for such sign-ups. Staff members have also been canvassing churches and community fairs in hopes of enrolling children in Medi-Cal.

The goal is to sign up 100,000 children for Medi-Cal by September 1999, according to public social services department Director Lynn Bayer. She said Tuesday that 19,000 youngsters have signed up so far in that effort.

Currently, Medi-Cal in Los Angeles County covers nearly 851,000 children, about one-third of the 2.77 million children--defined in this report as those under 18. But 314,000 more, nearly 50% of the uninsured children in Los Angeles County, may be eligible for Medi-Cal, according to the report released Tuesday.

In addition, Burke said Tuesday that she intends to call upon the Board of Supervisors to compel county contractors to provide information to their employees on various insurance options, including the recently begun Healthy Families program. As of July 1, that statewide program offers low-cost health benefits to children whose working parents do not qualify for Medi-Cal but who cannot afford coverage on their own.

Supervisors Burke and Gloria Molina complained Tuesday that Healthy Families registrations have gotten off to an unacceptably slow start--with an estimated 1,500 enrollees statewide. They blamed the relative trickle of applications in part on a dauntingly complex registration form that county health Director Mark Finucane compared to a tax return. Some states designed simple one-page forms to sign up for the program, which is mainly federally funded. The supervisors instructed Finucane to have staff members at county health facilities help people fill out the forms.

The report released Tuesday is the second in a series of studies that provides a more detailed profile of Los Angeles County’s uninsured population; it was conducted primarily by USC professor Michael Cousineau. Findings are based on a telephone survey of 8,004 households and on interviews with 2,363 parents.

The study estimated that parents of more than 750,000 children have problems paying for their children’s health services--meaning medical, dental and vision care.

Also, 17% of parents said arranging transportation to and from a doctor’s appointment is an obstacle. And 15% of children in Los Angeles County have no doctor whom they visit regularly.

The first of the reports, made public in April, said that many of the more than 2 million adults in Los Angeles County who lack health insurance are ethnic minorities who do not receive medical care when they need it. It also found that nearly half of Latino adults under age 65 are uninsured, as are more than a third of Asians.

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Times staff writer Ted Rohrlich contributed to this story.