FRENCH CAMP -- Rep. Jerry McNerney visited with patients and physicians at San Joaquin General Hospital on Wednesday and urged support for a nationwide program providing children with health coverage.
The State Children's Health Insurance Program, known in California as Healthy Families, expires Sept. 30. It offers low-cost coverage to children whose families make too much money to qualify for Medi-Cal but not enough to buy private insurance.
Both houses of Congress have passed bills to extend the decade-old program five more years but still have to vote on a final plan. President Bush has threatened to veto the legislation because it would make more children eligible.
The administration maintains communities should focus instead on serving more children who already are eligible. If the program expires without agreement, those enrolled could stand to lose their insurance.
"Health care costs are increasing so rapidly that we need to make sure all kids in the country have coverage," said McNerney, the Democrat from Pleasanton whose district includes San Joaquin County. "We are leaders of the industrialized world. There is no reason all children should not have health coverage."
Data varies on how many people in San Joaquin, Stanislaus and Merced counties are without insurance. Healthy Families covers about 40,000 people in the area.
David Hurst, director of Marketing for Health Plan of San Joaquin, which administers the program, said the organization doesn't know how many people locally would be eligible if the expanded criteria pass.
The money would come from reducing payments to private health maintenance organizations that provide Medicare coverage. Those costs are 12 percent higher than those in the standard Medicare program, according to analysts. The rest of the money would come from an additional 45 cents-per pack cigarette tax.
Critics take aim at eligibility changes in the legislation that allows the definition of a child to extend longer and increases income limits.
Those covered have their own primary doctor and are encouraged to seek preventive care so they don't end up in the hospital with more dangerous illnesses that are more expensive to treat, sometimes with public health ramifications, said Ken Cohen, director of health care services for San Joaquin County.
Dr. Susan Abraham, a pediatrician at San Joaquin General, described the case of a girl about 9 years old brought to the hospital about a year ago by her grandmother with a fever and difficulty swallowing.
"She had kept her home a couple of days and had now realized she really needed to be brought to the hospital, and we found she had an abcess and she had to go into surgery that day," Abraham said. "Mom and dad were working but they still couldn't afford basic health care."
U.S. Census data released late last month shows declines in the nation's poverty level but a rise in the number of people without insurance. The data also showed fewer employers are providing coverage.
Cohen described a presidential veto of the insurance program as "cutting up the infrastructure."
"You have all these programs we now provide that would end with a veto," Cohen said. "And we are saying, 'Please, people are going to lose preventative insurance.' "
Bee staff writer Inga Miller can be reached at firstname.lastname@example.org or 599-8760.