County Public Health Officer Dr. Charity Dean worries immunization funding could get caught in political crossfire, putting county residents at greater risk.
Paul Wellman (file)

Congressmember Salud Carbajal raised a hue and cry with county health-care officials about the current funding uncertainty hovering for a special federal insurance program targeting minors with parents who make too much to qualify for Medicaid but not enough to buy private insurance. As many as 30,000 kids and juveniles could be affected in Santa Barbara and San Luis Obispo counties unless federal funding is restored.

In 2017, about 11,000 patients received covered treatment via CenCal due to what’s known as the Children’s Health Insurance Program, or CHIP. Of those, many received vaccinations, dental care, and mental-health treatment. Three thousand received treatment for sexually transmitted diseases, HPV (human papillomavirus), or tuberculosis; 4,000 were treated for eye, ear, and nervous disorders; and 3,000 for asthma and related allergies. In addition, 415 pregnant women in the two counties received coverage thanks to CHIP, which has enjoyed strong bipartisan support in Congress since its inception in 1997.

Nationwide, the program covers nine million kids at a cost of $19 million. Congress missed this year’s funding authorization deadline of September 30, sidetracked by the intense debate surrounding a last-gasp effort by Republicans to repeal and replace the Affordable Care Act (ACA). That effort ultimately failed, as have efforts to find an alternative funding stream. Carbajal charged Republicans are trying to use CHIP to further destabilize the ACA. Republicans in the House Energy and Commerce Committee approved a plan to fund the kids’ insurance program last week, but only by raiding revenues Carbajal said would otherwise be used to underwrite key provisions of the ACA.

County Public Health Officer Dr. Charity Dean expressed concern that the Republicans might seek to fund the CHIP program with revenues that otherwise would go to the Prevention and Public Health Fund ​— ​part of the ACA ​— ​derided by critics of the health-care act as a “slush fund.” That fund, Dean said, supports most of the county’s immunization programs. Her office has so far in 2017 administered the hepatitis A vaccine to 883 minors and adults, in response to the state of emergency declared by Governor Jerry Brown for the virus. No cases have been verified in Santa Barbara County, Dean said, but given the interplay between people in Santa Barbara with Los Angeles and San Diego ​— ​where large numbers have been reported ​— ​precautions are warranted.

Likewise, Dean noted that it’s been 100 years since the last major flu pandemic, and the United States is due. She noted that early indicators for this year’s flu season ​— ​the experience of nations south of the equator ​— ​are ominous. Australia reported two times the number of influenza hospitalizations and deaths this year than in average years. Every dollar spent on immunization, Dean said, saves $64 in other costs.

If Congress doesn’t figure out how to fund CHIP, Carbajal said, it will fall to the State of California to underwrite the program. But that’s only if the State Legislature and the governor decide to do so. For the time being, they’ve agreed to fund the program, but only for the short term. In the meantime, Democrats and Republicans in Congress are trying to hammer out some kind of deal. “Everything’s a negotiation,” said Carbajal. As to what the Democrats are willing to give up to maintain funding for CHIP, he said he doesn’t know. But, he added, “What’s on the table now is not a viable option.”

Editor’s Note: This story was changed to reflect that County Public Health has administered the Hepatitis A vaccine to 883 children and adults.


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