‘MediKids’ Would Insure More Children

If it does not act quickly, California could lose more than $700 million in federal funds that are earmarked for the state’s Healthy Families program, which provides health insurance to children of low-income families. The funding is available, yet because of barriers to enrollment, hundreds of thousands of eligible children in the state remain uninsured.

Yet there are many ways to improve participation, including streamlining the enrollment process, expanding outreach and simplifying both the eligibility rules and the redetermination process that allows continued coverage.

All these things will help, but we also must recognize that parents may not make an effort to enroll their children in the absence of an immediate medical need. Therefore, the enrollment process must be made virtually automatic or participation rates will remain low.

Even if every eligible child were enrolled--an administrative impossibility under the current program--there are another half-million uninsured children in California who would not be eligible for either the Healthy Families or MediCal programs because their family incomes are too high. Yet these families are not able to afford other health insurance.

Our current efforts at reform have failed miserably. The number of children enrolled in Healthy Families has been offset by the decline in the enrollment in the MediCal program and an increase in the number of children who have lost their coverage because of termination of employment-based plans in which their parents could have been enrolled. What we need is not incremental reform, but sequential reform aimed at universal coverage.

To this end, Rep. Pete Stark (D-Ca.) and Sen. Jay Rockefeller (D-W. Va.) have introduced the MediKids Health Insurance Act of 2000 (HR 4390 and S 2515), which would establish a separate Medicare program just for children. The unique, defining feature of this act is that every child would be enrolled automatically at birth in the MediKids program. Parents could opt out only by presenting evidence of comparable private coverage. Any lapse of that coverage would cause an automatic return to the MediKids plan. When fully implemented, MediKids would assure every child of having health care coverage.

Participation would be an entitlement, as are Medicare and Social Security. The modest premium component of the funding would be collected at the time of submission of income tax returns, with a graduated discount for low-income individuals, assuring that coverage would be affordable for all.

With our great wealth, it is inexcusable that we leave so many children with insufficient access to medical care because they lack insurance coverage. The Stark-Rockefeller proposal is a painless way to end this national disgrace.