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The Need - Making the case for insuring our children

The healthy future of our entire community depends on what we do now to ensure all our children have access to medical care.

San Mateo County, one of the most affluent areas in the country, is the only Bay Area county with no plan to provide health care for its uninsured children. Despite such wealth, nearly 10 percent of the children in the county, about 17,000 kids between the ages of 0 through 18, lack access to continuous health insurance.

Nine out of 10 of these uninsured children come from hard-working families trying to provide for their children in jobs without health benefits. These working families cannot pay for privately purchased insurance since close to 90 percent earn less than 400 percent of the federal income guidelines, or $61,000 for a family of three, which is below the county’s estimated cost to raise a family.

Of course, lack of coverage affects our children’s physical and emotional development; when they can’t pay, parents skip preventive care visits for their children, forgo care for acute/chronic conditions, and only seek care, in an emergency room or inpatient setting, when the children need immediate attention. As a result, employers lose worker productivity from absent parents tending to their children. The County faces unnecessary short- and long-run costs as children end up in the emergency room, and we are all forced to care for a future generation of adults with physical and mental problems that could have been prevented with early care.

Our investment in ensuring access to health care today will guarantee our children the opportunity for physical and emotional growth necessary to reach their potential as adults.

For approximately $8 million per year, we can ensure that all children living in households with incomes under 400 percent of the federal income guidelines will have access to continuous health coverage.

What difference does insurance make?
Lack of coverage affects a child’s health status and access to care. Studies find that uninsured kids:

  • Are twice as likely as insured kids to forgo a doctor’s visit in a 12-month period and five times as likely to use the emergency room as a regular source of care.

  • Have a one and half times higher death rate than insured children.

  • Are almost twice as likely as insured kids to forgo care for chronic illnesses.
How will the Initiative cover uninsured children (ages 0-18)?
CHI covers uninsured children ages 0-18 through three insurance options: Healthy Kids, Medi-Cal, and Healthy Families. In addition, the initiative will cover the monthly Healthy Families and Healthy Kids premiums for families who face financial hardship and would have to drop their children’s coverage without assistance.

Healthy Kids will cover 5,350 children from families who earn less than 400 percent of the federal income guidelines and do not qualify for the existing Medi-Cal and Healthy Families programs. The initiative will also enroll approximately 9,250 children into Medi-Cal and Healthy Families by:
  • Building on existing outreach and enrollment efforts that increase access, assistance and the one-on-one trust needed to enroll many families;

  • Guaranteeing that all children within a family receive health insurance. Studies find that families do not seek coverage for their Medi-Cal and Healthy Families eligible children because other children within the family are not eligible.
These increased activities will expand the network of community-based organizations involved in outreach and enrollment and will enable several private and non-profit plans to participate in providing health care. For example, uninsured Healthy Families-eligible children will be able to enroll in Blue Cross, Blue Shield, Kaiser Permanente, Health Net, or the Health Plan of San Mateo.

A Bay Area movement to cover all children
San Mateo County joins Santa Clara and San Francisco counties in taking the steps to provide health coverage for all low-income and middle income children through Medi-Cal, Healthy Families and a new Healthy Kids program. These counties have all realized that inadequate access to health care for a large number of children leads to increased childhood illnesses, hindering their development and affecting the health of others. Providing 100 percent health coverage is small price to pay compared to the economic and social costs from increased illnesses to both insured and uninsured children.

The San Mateo County Children's Health Initiative is important to our children, their families and our county as a whole. Let us make sure every child has the opportunity for the physical and emotional growth necessary to lead a healthy life and reach his or her full potential as an adult.