State should stop playing shell games with children’s health

Dr. Anda K. Kuo
Dr. Anda K. Kuo

Back in April, children’s health advocates had real reason to celebrate. Congress had voted to reauthorize the Children’s Health Insurance Program, known as CHIP, with overwhelming bipartisan support. The program is a state-federal partnership that helps support the Medi-Cal program. The reauthorization would translate into $381 million in new funding for California this year, a windfall of cash to improve kids’ health care.

Now, scarcely a month later, our state’s leading children’s health experts are wondering where that windfall has gone.

When the May revision of the state budget was released, something strange had happened. The $381 million in federal funds were put into Medi-Cal, as expected, but there were no proposals to expand or strengthen the program. Instead, a similar amount of funding was taken out of Medi-Cal and put in the state general fund.

If you think that seems like an unlikely coincidence, you’re not the only one. It looks like the administration is playing a shell game – and they’re playing it with children’s health. The revised budget takes money intended for kids’ health coverage and diverts it to the general state coffers.

It’s hard to overstate the difference high-quality health insurance programs make in children’s lives.

The Children’s Health Insurance Program and Medi-Cal work together to keep kids healthy and keep costs down. More than 5 million California children are currently enrolled in Medi-Cal or CHIP. That’s over half of all kids in the state relying on these programs for everything from well-baby checkups to vaccination boosters to preventive dental visits.

The importance of quality state insurance programs in providing children’s health care was particularly clear during the recent economic downturn. Children Now’s health staff fielded a flood of calls from anxious parents seeking affordable coverage. Dr. Anda K. Kuo saw a surge of new children with chronic illnesses like asthma, whose families had lost their employer-based insurance. Those kids were still able to get the care they needed thanks to CHIP and Medi-Cal.

As any doctor will tell you, money spent on routine and preventive care will be paid back tenfold by avoiding the emergency and long-term interventions that become necessary when kids are forced to go without basic health services.

The math is simple. CHIP and Medi-Cal are a cost-effective solution to the problem of rising health care costs, when California has more kids living in poverty than any other state. Under these programs, health coverage per child is about $136 a month. The average emergency room visit – which uninsured families are five times more likely to use for routine care – costs nearly $800.

Burdensome health care costs can make it even harder for economically marginalized families to work their way out of poverty. Doesn’t it make sense for the state to invest in a program that keeps kids healthy and strengthens families – especially when the investment money comes courtesy of the federal government and is earmarked for that purpose?

Those federal dollars are crucial, because there are still plenty of ways to improve the Children’s Health Insurance Program and increase the number of children with health coverage. For example, we can work to ensure that every eligible child is enrolled and make it easier for doctors, dentists and other health care providers to participate in the program.

There is much work to be done if we want all California kids to be able to access affordable, high-quality care – and that work must be supported.

The diversion of the CHIP dollars to backfill the general fund is unacceptable. It’s like stealing from a child’s piggy bank, and advocates across the state are calling on the Legislature to make it right. Time and again, state budget priorities haven’t been in line with what Californians consistently say is their No. 1 concern: our children.

As they negotiate the budget, state lawmakers should remember that any investment made in children’s health is an investment in California’s future prosperity. We call on our representatives to do the right thing. Stop playing games and put the CHIP money to work for kids.

Dr. Anda K. Kuo is associate clinical professor and director of Pediatric Leadership for the Underserved for the Department of Pediatrics at the University of California, San Francisco. Kelly Hardy is senior managing director of health policy for Children Now.