San Jose Mercury News
October 8, 2000

A healthy landmark
Santa Clara County unveils an audacious plan to cover 69,000 kids who lack insurance; it could be a model for America
Editorial

There are 10 million children in the United States who have no health insurance. Making sure that each one of them gets coverage is a daunting challenge.

But if one county in America can rise to the challenge, then the rest of the nation will have footsteps in which to follow.

Santa Clara County is that county. Last week officials unveiled a preliminary plan to reach all 69,000 children who lack health insurance.

The idea for this ambitious -- even audacious -- plan came from Working Partnerships USA, a labor-affiliated research group, and People Acting in Community Together, a faith-based community organization. They estimate that 50,000 of the uninsured children are eligible for coverage under Medi-Cal or the state's Healthy Families program; all the county has to do is find them and sign them up. The rest could be covered by the county's HMO, the Santa Clara Family Health Plan.

The program is expected to cost $14 million the first year. With money coming in from the new Proposition 10 tobacco tax and the tobacco settlement, universal coverage is possible.

The original vision put forth by Working Partnerships and PACT was less ambitious: to provide coverage for uninsured children just in the city of San Jose, making it the first in the country to have universal coverage.

The idea was to use some of the millions of dollars a year the city was about to get from the tobacco settlement and the Prop. 10 tax. By pooling that money, it would be possible to do something big and bold, the groups said. Their idea was embraced by county supervisors, local health officials, educators and children's advocates. But it ran into opposition from Mayor Ron Gonzales, who did not want to use city money for health care.

Rather than give up the vision, proponents expanded it -- to include the entire county. That's the kind of attitude that moves mountains.

So far the county has amassed $7.9 million, enough to get started. There's $3 million in county tobacco-settlement money, $2 million in Prop. 10 money, another $1.9 million from the county general fund and $1 million from the Santa Clara Family Health Plan.

The first step -- outreach -- is the toughest part. Years of state and federal policy have discouraged immigrants from seeking benefits, leaving people fearful of signing up for any government program. A massive effort will be needed to canvass neighborhoods and educate people about children's health insurance.

The county recognizes that it's not just a problem for the poor. Many employers don't provide health coverage for children, and because the cost of living is so high here, thousands of working parents can't afford premiums. So families with incomes as much as 300 percent of the federal poverty level will be eligible for the county program. That's about $50,000 a year for a family of four.

The county is taking on a huge responsibility. It's counting on tobacco settlement money continuing to roll in for the next 20 years, along with state and federal money. This may be unrealistic, but it's still worth a try. With any luck, we'll have a national solution to the health insurance problem before this local effort must be curtailed.

Even now, however, more local help will be needed from foundations and other donors to fully fund the plan.

We hope San Jose will contribute. After resisting initially, Gonzales agreed to allow this program to compete for city tobacco funds. After all, half the children who need insurance live in the city. And when children are healthy, they do better in school. Their parents don't have to take time off from work. Families are more stable.

Children should not be denied health care because their parents can't afford it. Certainly not in the land of plenty that is Santa Clara County.