In the ho-hum news feed out of Sacramento, there is now a Groundhog Day quality of apparently never ending bad budget deficits. However, amidst all the anti-climax discussions of a final compromise on welfare and child care cuts between Democrats and the governor, one story deserving of attention that didn't blow through the roof is the impending elimination of a very popular health program for children. Namely the Healthy Families program that today covers close to 875,000 children would disappear over a one-year period and those kids will be transferred to Medi-Cal for their health care needs.
Healthy Families got started in 1997-98 under Gov. Pete Wilson. Plainly speaking, the Healthy Families program was/is the most successful government-sponsored initiative of the last 30 years. After a faulty start and paltry enrollment in its first three years of operation, the program kept growing and became responsible for the improved health of millions of kids from the ranks of the working poor. The kids benefited from it, the providers liked the reimbursement rates (much higher than Medi-Cal's), health plans sought after its contracts, and parents loved the respect of paying modest premiums and the feeling of doing well by your kids. But there are very few accounting gimmicks left, and a stubborn budget deficit of $16 billion is forcing state leaders to make some tough choices.
Despite a seasoned constituency and strong backing from powerful lobbies, Healthy Families may yet fall victim of the hard economic times that befall California. Although the Medi-Cal program is not anathema among poverty advocates such as myself, the blunt reality is that thousands of families-- the large majority of them Latinos-- will cry out in disbelief and discouragement. To add insult to injury, this plan doesn't make fiscal sense, because in order to score savings of $13 million in the upcoming fiscal year, the deal jeopardizes the opportunity to draw down nearly $200 million through a continuation of the Managed Care Organization (MCO) assessment for health insurance plans that participate in Healthy Families.
Make no mistake, closing down Healthy Families is either premature or unnecessary. Sure, federal health reform may have turned the program obsolete, but the state had many options at its disposal, one of which was to design a new health exchange around the program and leave Healthy Families mostly intact. With uncertainty looming in the hands of the U.S. Supreme Court, the state has closed that option forever, and even if the Affordable Care Care is found unconstitutional, Healthy Families will cease to exist.
After watching this last casualty of the budget ax, the middle class will likely turn a blind eye to the seriousness it represents. The seemingly simple decision of striking a successful and hugely popular program, could very well mark the beginning of the end, the last nail in the coffin of the Golden State of California and the California dream that to this day haunts its residents and beckons fee spirits and entrepreneurs from far-flung places around the world. This is no exaggeration; it is symptomatic of a grave condition. We could have done better, even under a major recession, if we were prepared.
We were helpless to stop the economic free fall, beginning with the energy crisis (remember Gray Davis), the sudden collapse of the dot com bubble, and finally, the implosion of the real estate market and the Great Recession of 2008. Primarily because the state lacked the resolve and political will to make necessary corrections in time. By now we all know the main reason: the State of California has become ungovernable indeed. The most sincere or desperate efforts from both sides of the aisle, always come to naught. In the span of one generation or two, we have managed to make every problem an intractable one, every debate a polarized imbroglio, and any attempted solution a short-sighted or ineffective one.
As if that was not tragic enough in and of itself, the saddest reality is that sometime after 1978 (coinciding with or caused by passage of Prop 13), the battle between the anti-tax forces and the progressive movement turned more acrimonious and dysfunctional. Since that time, without exception, each artful or historic compromise miraculously wrestled from a partisan Legislature has been litigated soon thereafter and stalled in court, or challenged by special interests with deep pockets who hijack the democratic process with ballot initiatives, and ultimately or often nullified by the voters. Is anyone listening out there ..? Anyone?
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