It was no accident that enrollment growth in California’s health
care program for children of the working poor was almost nil all
through 2004, but that doesn’t make the lack of expansion a good
It was no accident that enrollment growth in California’s health care program for children of the working poor was almost nil all through 2004, but that doesn’t make the lack of expansion a good thing.
Anything that diminishes the number of kids in the Healthy Families program started by Republican ex–Gov. Pete Wilson and accelerated under Democratic ex–Gov. Gray Davis is classically penny wise and pound foolish – in multiple ways.
But as the number of poor children rises steadily, enrollment growth in Healthy Families will likely get far lower under current Gov. Arnold Schwarzenegger and his new finance director, the former congressman and failed U.S. Senate candidate Tom Campbell.
Schwarzenegger’s proposed budget follows up on warnings by Campbell that “There will be a serious review of what we can afford going forward. Health and human services is a large part of the focus.”
The same “focus” happened to education, with Schwarzenegger and his new finance director trying for the second straight year to deprive elementary and high school districts of part of the money they’re guaranteed under the 1988 Proposition 98. That measure assured public schools a steady percentage of the state’s general fund spending.
Schwarzenegger says the people will rise up in protest if he doesn’t get his way on the budget and other plans, but it was the people who passed Proposition 98, determined to make sure that schools always get their piece of the state government pie.
Schwarzenegger got educators to pass up $2 billion their students were entitled to last year, helping him through a tenuous budget balancing act, but they may insist on their full share this time – since the governor promised last spring he’d never again try to swipe their funding.
If the schools insist on their rights, don’t expect Schwarzenegger and his budgeteers to do much besides cutting basics like welfare and health care even more than proposed in the putative budget they put out this week. That hits Healthy Families and Medi–Cal, both of which prop up the poor and the hospitals that serve them.
For governors can lose sight of the fact that when they cut health care programs serving the poor, they’re also striking hospitals. Reality is that when poor people have no insurance and a health crisis hits, they often head for emergency rooms – many of which must serve them, insured or not.
The more indigents get care in emergency rooms without paying, the more emergency rooms will close. And the more emergency rooms close, the fewer options for middle- and upper-class Californians when they have crises of their own. So it won’t just be the poor who get hurt if health care for the poor is cut down or cut out.
Reductions in the Healthy Families program are the most fiscally destructive of all. Not only would they steer more and more poor children to emergency rooms, they’d actually cost the state money.
That’s because California gets $2 back from the federal government for every dollar spent on Healthy Families. Which makes this one of the most constructive and positive ways for California to regain some of the federal tax dollars its citizens pay. So Healthy Families not only provides vaccinations and other preventive measures to kids who otherwise couldn’t afford them, saving both wear and tear and expense for emergency rooms, it also puts money into state coffers.
But Healthy Families enrolled only about 8,000 new children during the fiscal year ending last June. This was because of cutbacks in outreach programs stressed under Davis.
Chop the outreach programs even farther, as the Schwarzenegger administration contemplates, and there would be more stress on emergency rooms and fewer federal dollars to help out the state budget.
“We’re flooding emergency rooms with people who may have minor medical issues that should be addressed in clinics and doctors’ offices,” said one health insurance executive.
Cuts to Healthy Families, then, amount to little more than flailing about, with no real fiscal benefit and a large human cost.
But state parks have already been cut to the bone and admission fees increased. Highway funds have been raided to the tune of $4 billion in recent years and the governor wants to tap them again. Prison funding can’t be cut without early releases for hundreds or thousands of convicts.
Schwarzenegger and Campbell don’t want to go to these places to solve their projected $8 billion deficit. They can’t easily borrow their way out of this year’s bind, as Schwarzenegger did with two bond measures last spring. And they’ve pledged repeatedly not to raise taxes, even though they know a slight revision in regulations that govern property reassessments could solve the entire budget problem.
So they’re trying to balance the budget on the backs of welfare recipients and the working poor, both groups that don’t vote in big percentages and lack the means to protest very loudly if their services are cut or their fees increased.