Program a Booster for Children’s Healthcare

It has been more than two years since Vianey Lopez has seen the inside of a doctor’s office. When her father lost his farm job and a new assembly-line position provided no health insurance, the 17-year-old Oxnard student said medical care became a luxury her family no longer could afford.

Hers is like a growing number of California families that have lost job-based health coverage in recent years, people with no choice but to gamble that the next medical emergency isn’t lurking around the corner.

“We could use some kind of help,” the honor student said. “It would be nice to know that if something went wrong, we wouldn’t have to worry about what we were going to do.”

Help could be on the way. Joining an initiative that has taken root in more than two dozen California counties, a coalition of healthcare workers, social service providers and public officials has begun a campaign to deliver comprehensive healthcare to every child in Ventura County, where more than 30,000 youngsters lack coverage.

The Children’s Health Initiative seeks to provide a safety net for working families who earn too much to enroll their children in public programs yet can’t afford private insurance. It also would extend health coverage to youngsters barred from public programs because they are undocumented immigrants.

The initiative could cost up to $5 million annually, and supporters hope to raise a significant chunk of that money before launching the program early next year.

“This has reached a level of crisis,” said Maricela Morales, spokeswoman for a Ventura-based nonprofit group spearheading the local campaign. “Senior citizens have had guaranteed health insurance for 40 years. It’s time our children had equal protection and access to healthcare.”

Already, 11 California counties have launched the Children’s Health Initiative, including Los Angeles County, which in June embarked on the largest of those efforts in the state. Seventeen more counties are in the process of establishing the program that provides medical, dental and vision coverage to youngsters up to age 18.

Santa Clara County was the first on board. Advocates there created a program in 2001 designed to maximize enrollment in Healthy Families and Medi-Cal programs, which are funded by the state and federal governments. They also created a locally funded insurance plan called Healthy Kids for youngsters ineligible for public help.

Unlike public health insurance with its strict income limits, Healthy Kids allows a family of three to earn nearly $50,000 -- three times the federal poverty limit -- and still qualify for coverage. That same family would have to earn less than $40,000 to qualify for state-funded care.

The Santa Clara County initiative so far has extended health coverage to more than 77,000 children, with supporters raising $14 million a year to sustain the campaign. It also has had the salutary effect of drawing millions in new state and federal money into the county as a result of efforts to boost enrollment in government-funded health programs, according to one study.

That healthcare model is now in place in Kern, Riverside and San Bernardino counties, among others. Statewide, it has delivered the Healthy Kids component to more than 65,000 youngsters and has helped hundreds of thousands more enroll in existing public programs.

“The Children’s Health Initiative has been shown to be very successful in the counties where it is up and running,” said Liane Wong, director of the San Mateo, Calif.-based Institute for Health Policy Solutions.

“However, the programs are not sustainable beyond a few years without federal and state funding support,” she said. “A statewide solution is needed to ensure that all children have access to affordable, continuous and quality healthcare.”

Toward that end, a diverse group of supporters including teachers, business professionals and religious leaders launched a campaign late last year to provide universal healthcare for all California children by expanding the reach of county programs. The “100% Campaign” also will push for legislation to start building the statewide program so that it is available in every county by 2007.

About 1 million Californians under age 19 remain uninsured all or part of the year, according to the UCLA Center for Health Policy Research.

Last June, Los Angeles County officials established the largest Children’s Health Initiative in the state, with the goal of expanding medical, dental and vision coverage for 150,000 youngsters over three years.

Already, supporters have met $86 million of their $112-million fundraising goal. Major donors include the L.A. Care Health Plan, the Blue Shield of California Foundation, the California Community Foundation and the California Endowment.

The campaign so far has enrolled 34,000 youngsters in the L.A. County Healthy Kids insurance plan, for which parents pay monthly premiums of about $7 per child. Efforts to enroll youngsters in public health programs helped shrink the number of uninsured children from 384,000 in 2001 to 235,000 in 2003, according to the UCLA center.

“Our goal was to lead by example and show what could be done,” said Andrea Van Hook, spokeswoman for the L.A. County effort.

Ventura County has a solid road map to follow.

Its campaign kicked off late last year and received a boost in December when the Board of Supervisors unanimously supported exploring creation of the health initiative.

More than 300 individuals, civic groups and interfaith representatives have pledged support, and campaign leaders intend to ask county officials this summer to earmark funding for the effort. The plan also would seek money from private foundations, business interests and other community sources -- a tall order in tough economic times.

“Just because it’s a challenge doesn’t mean we shouldn’t take the first steps,” said Supervisor Steve Bennett, who with Supervisor Kathy Long asked that the idea be investigated. “Healthcare is broken in this country and we should try to do what we can to fix it.”

Roughly eight in 10 of Ventura County children have health coverage through their parents’ employer or through public programs, leaving about 32,000 uninsured. Officials estimate that about half of the uninsured qualify for Medi-Cal and another quarter for Healthy Families, and could be covered through stepped-up recruitment to those programs. That would leave about 5,000 youngsters in need of the locally funded Healthy Kids, at a cost of about $1,000 a year per child.

Although primarily aimed at the uninsured, the initiative also seeks to provide a safety net for working-class families at risk of losing the coverage they have.

That safeguard can’t come soon enough for Kiley Mercado, a Ventura mother of three struggling to stay afloat amid a rising tide of medical bills and prescription co-pays. A pharmacy technician at a local grocery store, Mercado said she was forced last year to cross the picket line during the Southern California supermarket strike in order to maintain health coverage for her children, the youngest of whom has cystic fibrosis.

And since the strike ended, she said she has found herself funneling a larger portion of her monthly earnings toward medical expenses, increased costs largely driven by her son’s illness.

“I’m not asking for someone to take care of my son’s medical needs, but it would be nice to know that there was some help available,” said Mercado, 26. “I want to work, I really do. But we’re middle class, and there just isn’t a lot of help out there for middle-class people.”