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Health Care Solutions

April 18, 1999

One in five Californians lacks health insurance and 50,000 more people join their ranks each month. The huge gaps in coverage add up to a seriously frayed social safety net; Los Angeles County--where 35% of all adults are uninsured, compared to 22.7% of the statewide population--is at the epicenter of the crisis.

California has the means to solve a good part of the problem: Washington has set aside $855 million a year to extend health coverage to the state's 1.7 million uninsured children in a program called Healthy Families. Of the $1.7 billion the state has received so far for the program, it expects to spend no more than $150 million. If it does not allocate the rest within a year, the federal government will redirect the money to other, more eager states.

Here are ways the state and county can work together to spend that money wisely:

* Streamline eligibility requirements for Medi-Cal and Healthy Families. Earlier this month, the state released a simplified application for Healthy Families. Now, Sacramento legislators need to consider six pending bills that would further streamline the state's public health insurance system. Easiest to implement is a sensible measure by Senate President Pro Tem John Burton (D-San Francisco) that would allow people to apply for public health insurance by mail.

* Use Healthy Families dollars to expand school health care beyond the traditional public-health functions such as screening and immunizations. Last month, Los Angeles County Supervisor Zev Yaroslavsky and Los Angeles City School Superintendent Ruben Zacarias launched a program in conjunction with Healthy Families that will provide unprecedented access to primary health care to the hundreds of thousands of public school students who lack health insurance. The program will provide on-campus services to more than 270,000 students in the district.

* Urge the federal government to reassure recent immigrants that they will not risk deportation or other penalties if they send their American-born children to public health clinics. Many Latinos fear that if they sign their children up for health benefits, they will be deemed "public charges" under federal immigration law, and harm their chances of future U.S. citizenship or even risk deportation. Federal officials need to explicitly tell state officials what they have only implied so far: that they don't view publicly funded health care coverage in the same light as cash assistance or food stamps.

* Finally, Sacramento should follow the lead of states like Massachusetts and Wisconsin and ask Washington for waivers to use some of the Healthy Families money for parents as well as their children.

Everyone loses when politicians allow public health problems to escalate, for infectious diseases easily cross social and income groups, and all taxpayers are burdened when costly emergency rooms, instead of family doctors, provide basic medical care.

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