As more and more children and families continue to lose employer-based health insurance due to the economic downturn and the ballooning cost of coverage, federally- and state-funded children’s health programs should be expanded and improved. The added public expenses associated with uninsured children—including forcing reliance on emergency room care, limiting the availability of necessary immunizations, and denying mental health services when needed—are unaffordable.
When children have health insurance, they are more likely to receive routine preventive health care, which protects them from avoidable diseases and facilitates early diagnosis and treatment when they are sick. Without health insurance, families often forgo preventive care, choosing to access health care only when their children are seriously ill. As such, illnesses that could have been treated easily at earlier stages become much more severe. In addition to undermining children’s health, this delayed approach to care costs the public significantly more than preventive services as care is often accessed through expensive emergency care providers.
Prior to 2009, California made steady progress on increasing the percentage of its children with health insurance. Between 1998 and 2007, the number of California children without coverage decreased by approximately 675,000, from 19% to 11%. The 2009-10 California budget, however, cut $196 million in funding for Healthy Families, the state’s main public health insurance program, thereby reversing the years of progress. Poor decision-making by the state also forfeited $360 million in available federal stimulus matching funds for state-funded health insurance programs.
California only narrowly averted total disaster by backfilling the $196 million budget cut to Healthy Families through one-time funds from First 5 California and Assembly Bill 1422, which provides $97 million to Healthy Families in 2009-10 and $49 million in 2010-11, and roughly $17 million from new increases in families’ out-of-pocket costs. But major funding problems remain on the near-term horizon.
Even after backfilling the budget cuts to Healthy Families, national surveys report that more than one million (11%) California children remain uninsured. In addition, more children than ever are becoming uninsured through their parents’ unemployment and loss of employer-based health coverage, and health coverage in general is becoming prohibitively expensive and less accessible. So far, California’s rising unemployment has resulted in 680,000 children becoming uninsured between 2007 and the present.
California cannot afford to let the ongoing budget crisis cloud its judgment of the benefits of providing public health coverage to all children that need it. The state should build on the reauthorization of the federal Children’s Health Insurance Program (CHIP) in early 2009, which reflected a commitment to children’s health coverage. Moreover, California can learn from other states: even in tough economic times, 23 other states implemented changes or enacted legislation to increase the number of children and families receiving health coverage through Medicaid and CHIP. California was one of only three states that enacted policies to cut children and families from Medicaid, CHIP or both in the same time period.
Given a full economic recovery is projected to take several years, California must prioritize a long-term, sustainable approach to ensuring every child has access to affordable health insurance.
As policymakers in Washington, DC develop plans to reform America’s health care system, the needs of the country’s children should be a priority. We must ensure that any health reform proposal guarantees affordable, comprehensive, high-quality health coverage for all children—including the 10 million children in California.
For more information, please see the Georgetown Center for Children and Families’ health care reform page.
On February 4, 2009, President Obama signed the Children’s Health Insurance Program (CHIP) reauthorization bill - H.R. 2 (CHIPRA 2009). With the successful passage of CHIPRA 2009, Congress and President Obama demonstrated a strong commitment to covering the nation’s uninsured children during this difficult economic time. This new federal leadership on children’s health gives California an opportunity to draw on federal funding to provide health coverage for the roughly one million uninsured children in the state.
California leaders have the responsibility to do their part to capitalize on the newly available federal funding for children’s health insurance. If they fail to do so, CHIP funds will be distributed to other states and California’s children will be needlessly left out. This is the moment for California’s leadership to step up for children as many other state leaders are doing.
Download a brief summary of the key provisions in the federal CHIP bill and what California will need to do to take advantage of the opportunities presented in the legislation.