A healthy strategy


GOV. ARNOLD SCHWARZENEGGER may have a hard time persuading the Democratic leaders of the Legislature to accept his apparent return to centrism, despite his recent backing of a raise in the minimum wage, elimination of a fee increase at state universities, higher school spending and legalization of prescription drug purchases from other nations where commonly used drugs are cheaper. If he’s sincere about reviving the Arnold whom Californians thought they had elected in 2003, he would get more mileage from taking on broader healthcare issues.

Rising healthcare costs and the problem of California’s 6.5 million uninsured people may become this year’s big issue. The governor should look well beyond prescription drug purchase plans, which in other states have been lightly used by consumers. Schwarzenegger last year vetoed bills aimed at reducing drug costs, and his new call for federal legalization of foreign drug purchases is mostly hollow because pharmaceutical companies have effectively blocked any congressional moves in that direction.

One bright spot that fully deserves the governor’s backing is the state’s Healthy Families insurance plan, which uses state and federal money to offer health coverage to the children of working families. Healthy Families is one of the few bright spots in California’s troubled healthcare picture. Largely because of the program, health insurance coverage jumped from 83% of the state’s children in 2000 to 88% in 2004, according to a UC Berkeley study, even as adults increasingly lost employer-based insurance.


However, even as states such as Illinois were expanding similar plans to cover some adults, Schwarzenegger last year briefly cut California’s outreach to eligible families, which had the effect of reducing the number of new children enrolled.

Healthy Families still offers the possibility of universal care for children, and some healthcare reform advocates see it as a model for state-provided health insurance for all. Users of Healthy Families are charged premiums on a sliding income scale. Families of four with earnings of about $48,000 a year are eligible.

The need for the program is magnified by the state’s temporary 5% cut in payments to doctors treating very low-income families who are covered by Medi-Cal, the state’s version of Medicaid. Healthy Families is also used as a platform by counties -- including Ventura and Los Angeles -- that are expanding local coverage to include undocumented children not allowed into federal and state programs.

California, despite rising tax revenues this year, still faces a long-term structural budget deficit. Schwarzenegger and the Legislature have to pick their targets for new spending wisely. Because Healthy Families has broad public support and federal funds cover two-thirds of its cost, it offers a lot of bang for the buck.