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Ill children may get bad news

Enrollment in state insurance program for poor may be capped.

November 14, 2008|Jordan Rau | Rau is a Times staff writer.

SACRAMENTO — State officials are considering capping enrollment in California's health insurance program for children of the working poor, as an influx of new clients overwhelms it.

If the Healthy Families Program were to be restricted, it would be the first such drastic action in its 10-year history, advocates said. As many as 162,750 children could end up on a waiting list within six months, according to a memorandum from Lesley Cummings, the executive director of the Managed Risk Medical Insurance Board.

The board administers the program, which provides medical insurance for 900,000 children. About 27,000 new children have been signing up each month, and the program now projects a $17.2-million deficit if no action is taken.

The board is planning to make a decision in mid-December, Cummings' memo said. To achieve the necessary savings, the waiting list would have to be established Dec. 18.

"If the board does not cap enrollment, it would have to take other, more drastic actions later," Cummings wrote to the board's members. "Capping enrollment, rather than eliminating coverage that a child currently has, seems the preferable path."

Children of families who earn up to 250% of the federal poverty level are eligible for Healthy Families. That translates to incomes of $3,667 a month for a family of three and $4,417 a month for a family of four. Those below the poverty line are entitled to healthcare through the state's Medi-Cal program.

Children's advocates said this would be a cruel time to restrict the program, as so many families are losing insurance along with their jobs in the bad economy.

"There is this demand and rather than meeting it, we're actually shutting the door," said Anthony Wright, executive director of Health Access California, a nonprofit group.

The Legislature still has time to authorize more money for the program. Lawmakers are in special session to deal with the state's growing budget gap, which is projected to reach $27.8 billion over the next 20 months.

"We're hoping the Legislature will take this up, because they have always funded this program," said Kristen Golden-Testa, health director of Children's Partnership, a Los Angeles-based advocacy group.


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