Program Helps Insure Children

When kindergartener Michelle Lara suffered ear infections or high fevers, her mother took the Santa Ana 6-year-old to local emergency rooms for care, paying as much as $1,200 per visit. Michelle wasn’t covered by health insurance.

That changed when Michelle recently enrolled in a novel program in Orange County that offers free or low-cost health insurance to thousands of uninsured Orange County children.

“Now that she has insurance, my daughter has her own pediatrician,” said Michelle’s mother, Carolina Silvas, a homemaker and native of the Mexican state of Sinaloa. “My daughter will be healthy in the future because she will get regular checkups.”

Well over 8 million children nationwide lack health insurance, including nearly 1.3 million in California, according to census data.

“It’s an indicator of a healthcare system nationally that is quite broken, and ... leaves some of the most vulnerable in our society uncovered, with no access to needed healthcare,” said Larry K. Ainsworth, chief executive of St. Joseph Hospital in Orange.

Last year, Ainsworth and officials with St. Jude Medical Center in Fullerton, Mission Hospital in Mission Viejo, Kaiser Permanente medical insurance and the county-based Children’s Health Initiative launched the 100% Campaign to provide health insurance to the roughly 40,000 uninsured children in the county.

If eligible, children are linked with state programs such as Medi-Cal; otherwise, they are enrolled in a Kaiser plan that costs at most $17 per month. A child’s immigration status is not a consideration in the Kaiser program.

“We appear to be a wealthy county with few needs of that sort, but that’s a huge number,” Ainsworth said. “Our goal is to reach every single one.”

The coalition plans to spend $3 million over three years to identify every child in the county lacking health insurance, enroll them in either free or low-fee insurance plans, and provide a year of follow-up care in which families are assisted in selecting physicians, making appointments and finding transportation.

The county in December also agreed to dedicate nine employees to linking uninsured children with state health insurance programs such as Medi-Cal and Healthy Families.

About 11,000 children have been enrolled in various programs since July.

“This shows what we can do working in a private-public partnership and doing what we need to do to” so that every eligible child is insured, said Supervisor Lou Correa, whose proposal to spend $2.1 million to boost the county effort was rebuffed by the whole Board of Supervisors last year.

Many uninsured children have come to the coalition’s attention through elementary school officials.

At Grant Elementary School in Santa Ana, one-quarter of the school’s 350 students did not have insurance at the beginning of the school year.

Today, the school will celebrate all of its students having coverage.

“This is the best opportunity in the world for them,” said Principal Brian Martinez. “Without this insurance, these parents could not [afford] preventive care. The children would continue going to school ... with rotten teeth or stomach problems or with other medical problems that would be ignored because they couldn’t afford it.”

In addition to the well-established benefits of preventive care, local schools will gain.

Fewer sick children means more students in school every day, which translates into more state funding.

School districts across Orange County lose an estimated $100 million per year in funding because of student absences, according to an October report by the county Health Care Agency.