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Beach Post Silicon Valley
county finds health coverage for almost all kids SAN JOSE, Calif. — In the heart of Silicon Valley, the message is a simple one to the low- to moderate-income parents of children without health insurance: Sign up your child for the Santa Clara Family Health Plan and your son or daughter will be covered. No matter what. Unlike the dizzying array of restrictions with most state and county child health insurance programs, Santa Clara County's Healthy Kids program has some of the easiest eligibility requirements in the nation. Families can have incomes as high as three times the federal poverty level ($58,000 for a family of four) and still qualify for health benefits. Moreover, the only requirements are to live in the county and have no other health coverage. Launched in 2001, Santa Clara's privately financed Healthy Kids program has enrolled 30,000 children, reducing the number of uninsured children in the county to about 15,000 from 71,000. A big reason for the drop is that when parents apply to Healthy Kids, the program increasingly finds that children are qualified for Medicaid or the State Children's Health Insurance Program. Counting these programs, the Santa Clara initiative has extended health coverage to more than 77,000 children. Almost immediate dividends Getting children covered by health insurance pays almost immediate dividends. A study by the research group Mathematica Policy Research found Healthy Kids members are nearly twice as likely to report having a regular doctor to go to. For fathers such as Alberto Oliva, 37, of San Jose, the Healthy Kids program is the only way he can get medical insurance for his 4-year-old son, Alberto Jr. "I greatly appreciate it," Oliva said recently when renewing his son's coverage in the Healthy Kids program at an office just south of San Jose. Oliva, who cleans pools, can't get health insurance from his employer and he makes too much to qualify for Medicaid. Children enrolled in Healthy Kids get to choose from the same large network of area doctors and hospitals participating in the county's Medicaid HMO, the Santa Clara Family Health Plan. The HMO administers the plan, processes applications from families and pays medical claims. In addition, the program provides vision and dental coverage. Parents pay small premiums (no more than $18 a month) and co-payments on a sliding scale. Fees are waived for those who can't afford them. The Healthy Kids initiative was developed by a coalition of community groups, county agencies and the local Medicaid health plan to improve the health and well-being of low-income children in Santa Clara County. Drawback: Waiting list The program is a huge help among the big migrant population here because Medicaid covers only U.S. citizens. About 80 percent of the children in Healthy Kids are undocumented. Healthy Kids is financed by state tobacco-tax money, the city of San Jose, the county's share of the tobacco lawsuit settlement and contributions from private foundations. It costs about $14.5 million a year. The only problem with Healthy Kids is that it's been too successful. So many parents have sought health insurance for their children that the program had to start a waiting list last year. Today, about 1,000 children are on the list, but because of turnover, kids are usually on the wait list no more than six months. Santa Clara County's program is being copied by several counties in California, including San Francisco, San Mateo and Alameda counties. In San Mateo, home to Stanford University, income eligibility goes up to four times the poverty rate, so a family of four earning $72,500 can still qualify for the subsidized coverage. Craig Walsh, a former marketing executive for the San Francisco 49ers who is the executive director of Santa Clara's Healthy Kids program, said one of the keys to its success is the simple message to parents. "We could tell them, just come in and we will be able
to sign up your child for coverage," Walsh said. |
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