Health care for kids might pass

With no end in sight, California's budget impasse is threatening to derail Gov. Arnold Schwarzenegger's top legislative priority -- universal health care.

But some health care advocates remain optimistic that the governor's proposal to expand health care for children -- perhaps through opening more clinics in elementary schools -- might have a chance.

"It seems a no-brainer that the very least that we should be able to get accomplished is to cover all the kids, because it's so widely supported in diverse communities," said Kristen Golden Testa, director of the California health program for the advocacy group Children's Partnership.

The Republican governor unveiled a $12 billion plan in January that would provide health care access for the 6.5 million children and adults in California without insurance.

But the budget stalemate, now in its second month, has delayed legislative action on his proposal and a separate Democratic plan by Senate President Pro Tem Don Perata and Assembly Speaker Fabian Núñez.

Even the eternally cheerful governor has accused Senate Republicans of delaying the budget to stall health care negotiations, which must conclude before the Legislature adjourns on Sept. 14.

"There are politicians in Sacramento who are holding up the budget so they don't have to go into health care reform," the governor said at a recent health care summit.

For now, as one component of his universal health care plan, the governor is proposing to add 500 clinics in elementary schools, to lower opposition from conservatives who object to dispensing birth control information to teenagers.

Schwarzenegger announced his clinic expansion proposal at a health care summit a year ago. Three months later, the governor signed Assembly Bill 2560 by then-Assemblyman Mark Ridley-Thomas, increasing cross-agency collaboration to gather data about services delivered by school health centers throughout the state.

Ridley-Thomas, now in the Senate, is concerned that a comprehensive health care plan may not be enacted this year but said expanding school-based clinics could still be done.

His Senate Bill 564 would create a grant program to support planning and expansion of clinics -- with the funding source yet to be determined.

"This is an effort to support academic achievement, to keep kids healthy and do it in a cost- effective way," the Los Angeles Democrat said.

Most of the 147 clinics now serving schools in California are in low-income communities and high rates of people without insurance. The clinics provide services to students directly on school campuses, at off-site facilities that are linked to one or more schools or in mobile vans that serve multiple campuses.

According to a draft report by the governor's advisory group on school-based health centers that was obtained by The Bee, these clinics are well-positioned to serve children in collaboration with school districts, community groups and other entities.

But the 40-member group, which met over the course of three days in June under the leadership of Herb Schultz, senior health policy adviser to the governor, was silent on where the money would come from to add more clinics.

Funding for school clinics currently comes from a patchwork of sources, including money from Medi-Cal and private insurers, school districts and private foundations. California is the only state with school-based clinics that does not provide direct funding.

Even with the stalled budget, Núñez said he is committed to passing legislation this year that includes universal health care for children.

Senate Republican leader Dick Ackerman, R-Irvine, said the budget impasse and the health care overhaul proposal are "totally unrelated."

But no one disputes that the clock is winding down and that much work needs to be done. Schwarzenegger's overall proposal, for example, would require a $1 billion contribution from counties in the state.

But counties that don't run their own hospitals -- and thus, would not benefit from proposed Medi-Cal rate increases -- are balking, said Kelly Brooks, legislative representative for the California State Association of Counties.

Schwarzenegger is also counting on $3.7 billion in annual subsidies he has been requesting from the federal government to expand the Medi-Cal and Healthy Families programs, but the 2006 federal budget calls for $4.6 billion in health care cuts to California over the next decade.

Alex Briscoe, deputy director of health care services for Alameda County, said that based on conference calls he's had with other county officials, "there's a sense" that comprehensive health care change will not happen this year.

"The best we can hope for right now is expansion of Healthy Families and Medi-Cal, so all kids get covered," Briscoe said.

Kim Belshé, Schwarzenegger's secretary for health and human services, dismissed such talk and said the governor remains "committed to comprehensive health care reform."

"The folks who advocate a particular piece of health care reform are people who believe that if comprehensive reform doesn't pass, their piece can," Belshé said.

Anthony Wright, director of Health Access California, a statewide health care consumer advocacy coalition, said there is still time to make comprehensive changes this year. He cited major deals that have come together at the end of legislative sessions, including last year's landmark global warming law.

Wright said the best chance to provide coverage for uninsured children would be through a comprehensive plan because there is currently no funding proposal to cover just children.

Meanwhile, the end of this year's legislative session is less than a month away as the budget stalemate enters its 51st day today.

"Something as monumental as health care reform is very complicated," Brooks said. "At the very least, whatever they put together in September will likely require some sort of cleanup and additional work."

About the writer:

• The Bee's Aurelio Rojas can be reached at (916) 326-5545 or arojas@sacbee.com.