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Largess for the Littlest

June 22, 2004

It seems a bit perverse that the only way some children in Los Angeles can get healthcare is through the kindness of charities. But philanthropists' announcement today that they will donate $112 million over the next three years to expand medical, dental and vision coverage for 150,000 Los Angeles County children is nonetheless extremely welcome.

The aim of the charities putting up the money, as California Endowment CEO Bob Ross puts it, is to "fulfill the moral imperative to insure our children." There are also, however, savvy political reasons for the move.

One goal is to keep California from squandering federal healthcare dollars in the future. Last year, California returned a whopping $700 million in children's healthcare funding that Congress had set aside for the state. The reason was that legislators weren't sure they could pony up the required 33% in matching funds.

Another goal is to twist government's arm into insuring children statewide for the long term. The philanthropists are wagering that the money will encourage other counties in the state to expand their children's health coverage as well. They also hope that once the private dollars run out -- the $112 million is a one-time contribution -- it will be morally awkward for government to kick the children insured by them off the rolls. A cynic might suggest that because most of the money is coming from charities funded largely by the health industry, this is merely a way to boost insurers' business in the future, but getting more children on the rolls is a highly desirable goal no matter how it happens. As Gov. Arnold Schwarzenegger put it during the recall campaign, "Every child in California should be insured."

Of course, the choices now facing Californians aren't quite that simple. The governor, for instance, recently decided to cut about $900 million from the state's $11-billion share of Medi-Cal spending -- a slice that may, among other things, mean terminating future health aid to many elderly and disabled people living at the federal poverty level. Given draconian cuts such as these, some state officials are rightly wondering whether now is the right time to create a statewide version of the generous children's healthcare program the donation would fund in Los Angeles County, which would offer coverage to children in families with incomes of up to about $55,000 a year.

There are no easy long-term answers to such questions. In the short term, however, the benefits brought by $112 million are hard to ignore. The money will help meet the governor's goal, while pressuring legislators to at least begin addressing long-term solutions.

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