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Not worth the paper

New Medi-Cal proposals put budgets and bureaucracy ahead of children's health.

June 27, 2008

With the state budget in such dismal shape, it's all the more important to spend money wisely, on those who need it most -- and not on increasing paperwork. Gov. Arnold Schwarzenegger and the state Senate should drop proposals that would force the parents of children on Medi-Cal to re-enroll them more than the current once a year. The governor has called for renewal four times a year; after the Assembly rejected that idea, the Senate floated a compromise of twice a year.

Adults in California already must apply twice yearly, but the state has long allowed children's coverage to extend through the year to avoid lapses in medical care, even if their parents fail to re-enroll or are no longer eligible. The change is proposed as a budget-saver by taking children off the rolls when their parents earn too much money to qualify. If only it were that simple.

This isn't about medical coverage for 3 million children versus schools, or healthcare versus prisons. This is healthcare versus increasing the number of forms people must fill out and increasing the number of bureaucrats to process all those forms. It was tried as a cost-saving measure in Texas and Washington, and both states dropped it after a couple of years when they found that they had underestimated the number of children who would go without healthcare, as well as the costs of processing the extra applications. Washington had to hire the equivalent of 160 full-time workers to handle the load. California, with nearly 10 times as many children on Medi-Cal, would have to do a lot more hiring.

Many of the children eliminated from the rolls were back on within a few months. Some of them had always been eligible, but their parents failed to keep up with the new paperwork requirements. Other cases involved children who requalified when they needed particularly expensive medical care, so the state saved money on the small-ticket items but not the big ones.

The semiannual applications are projected to save California $25.6 million while taking medical coverage away from tens of thousands of children. Meanwhile, the costs of doubling the paperwork#zzee_link_1_1202952761 would erase much of the savings. The health of poor children is a vital social interest; more paperwork is not.

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