Health Care Coverage For Children Top Issue In California.

California’s state legislators and county supervisors overwhelmingly support new state efforts to increase the number of children who have health insurance in California, according to a survey conducted by the Tomás Rivera Policy Institute (TRPI) in conjunction with the Division of Community Health in the Keck School of Medicine, at the University of Southern California. Collectively, officials rank health insurance coverage for children as one of the top issues confronting the state in the next two years. While the top issue of concern for improving the well-being of families is solving California’s budget shortfall, making health insurance more accessible and affordable ranks second. When asked about improving health care for children, officials indicate even stronger support for making health insurance coverage more accessible and affordable.

“These statistics point to the fact that California’s elected officials understand there is a problem out there and that something needs to be done to fix it,” said Harry P. Pachon, President of TRPI. “The issue ultimately lies with what that fix looks like, but there is no denying there is a problem.”

According to TRPI, an overwhelming number of officials (72%) agree that new state efforts are needed to increase the number of children who have health insurance in California. Additionally, 64 percent of officials believe that eligibility for Medi-Cal and Healthy Families should be expanded. When asked if their colleagues support increasing children’s health insurance, four out of five legislators perceive similar support levels amongst their peers for some state involvement. Survey results also indicate substantial support (56%) amongst elected officials for extending health insurance coverage to all children, regardless of immigration status.

“Elected officials seem to agree that protecting the health of children is an important policy goal although there is disagreement about how to get there,” said Michael R. Cousineau, Director of the Division of Community Health. “There may be a role for the federal and state governments, local government, business and parents.”

While elected officials indicate strong support for voluntary employer efforts to improve health insurance coverage for children, there is significant opposition to requiring employers to extend benefits. For example, 76 percent of elected officials support efforts to make the private health care system more efficient and competitive, and thus more affordable for employers, but one out of two oppose any requirement that employers extend health insurance benefits to their employees’ dependents.

TRPI also found that, of those elected officials who claim to reside in counties with children’s health initiatives that are either fully implemented or in the design phase, 73 percent support a statewide program to cover all low income children, regardless of immigration status. Currently, there are 12 counties throughout the state that have implemented children’s health initiatives, with another 18 that have initiatives in the design or planning phases.

“Right now there is a commitment on the part of our elected officials to find a solution. At the same time, they are struggling to find the best information available to them and their constituents so they can make informed decisions about health care,” added Pachon. “There are a number of success stories out there at the county level, but no one knows where health care costs are going and what impact that will have on businesses.”

Indeed, elected officials believe there is a dearth of information available to them and their constituents when it comes to the issue of health care coverage, particularly in the areas of health insurance coverage rates (24%), costs of health care for children (27%), and utilization of child health care services (24%). Moreover, approximately one in five elected officials indicate a lack of information on at least one major health care issue.

The survey was carried out by mail from March to June of 2005. In the survey, 295 county supervisors and 120 state legislators were asked to rate where children’s health insurance falls among competing priorities; who should be responsible for uninsured children; and, in the current legislative session, what the perceived level of support or opposition was among colleagues to provide health insurance for California’s children. Follow-up phone calls and two site visits to state legislators’ offices in Sacramento were made. One hundred and nine officials participated in the survey, resulting in a 26 percent response rate with a margin of error of 8 percent. Specifically, 33 percent of California legislators and 23 percent of all county supervisors participated in the survey. Survey respondents represent all geographic regions of California. TRPI statistically weighted the data so as to reflect the partisan makeup of the state legislature.

TRPI’s research team included Harry P. Pachon, Ph.D., Jongho Lee, Ph.D., Hayley Buchbinder, M.P.P./M.H.A., David Fabienke, M.P.P., and Angelo Reyes, M.P.P. Candidate, in conjunction with Michael R. Cousineau, Dr. P.H., and Gregory D. Stevens, Ph.D. from the USC Division of Community Health at the Keck School of Medicine.

Survey of California Supervisors/Legislators Perceptions of Children’s Public Health Insurance

2005
In general, how strongly do you agree or disagree that any new state efforts are needed to increase the number of children whohave health insurance in California?

Strongly Agree (50.5%)
Somewhat Agree (21.4%)
Somewhat Disagree (4.4%)
Strongly Disagree (11.6%)
Neither Agree nor Disagree (12.1%)

In meeting the health insurance needs of children in California, the state should….

Expand eligibility for Medi-Cal and Healthy Families

Strongly Agree (43.9%)
Somewhat Agree (20.5%)
Somewhat Disagree (12.7%)
Strongly Disagree (8.3%)
Neither Agree nor Disagree (11.8%)

In general, how strongly do you favor or oppose the state providing public health insurance coverage to low-income, uninsured children regardless of immigration status?

Strongly favor (41.1%)
Somewhat favor (14.7%)
Somewhat oppose (2.7%)
Strongly oppose (27.5%)
Neither favor nor oppose (12.2%)

Require employers to extend health insurance benefits to their employee’s dependents

Strongly Agree (9.8%)
Somewhat Agree (25.5%)
Somewhat Disagree (12.8%)
Strongly Disagree (42.2%)
Neither Agree nor Disagree (6.2%)

For which topics related to children’s health, if any, do you have INADEQUATE information available to you in making informed decisions about children’s health and health care? Please check all that apply.

Health insurance coverage rates (23.7%)
Enrollment in Medi-Cal and Healthy Families (15.5%)
Utilization of child health care services (23.7%)
Costs of health care for children (26.9%)
Quality of health care for children (21.7%)
Access to health care for children (14.4%)
Health status among children (23.2%)
Safety net providers for children (22.9%)
Other: (specify) (6.3%)
Not sure (11.5%)

For more information at http://www.trpi.org