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SAN JOSE — Momentum for children’s universal health care is spreading to cities throughout California, a trend that goes against scaled-back state support for the uninsured. 

Five months ago, San Francisco followed Santa Clara County’s successful plan. Now, it has 1,000 children enrolled. 

“We are limited only by our imaginations; it could go statewide within a year,” said Jean Fraser, chief executive officer of San Francisco’s health plan. “And it’s incredibly critical, with the funding cuts, that we do something.” 

Gov. Gray Davis’ proposed budget includes cuts in health services to help shrink a $23.6 billion shortfall. It would eliminate 300,000 working parents from state-funded health benefits, reducing children’s dental checkups from biannual to annual, and suspending plans to expand state-funded health care to working poor families. 

The county programs rely on various sources resources to provide the health care, including general fund money, private donations, and money from tobacco settlements and cigarette taxes. 

“A current notion says that we all must share in the pain of the budget crisis,” said San Mateo County Supervisor Jerry Hill, when announcing a $7.7 million initiative. “The children of San Mateo County shouldn’t have to share that pain. We’ll do all we can to see that they don’t.” 

The state has about 1.6 million uninsured children with a death rate that’s about 150 percent higher than those with health coverage. 

Most local insurance programs rely on increasing enrollment for existing health care programs such as Medi-Cal and Healthy Families. Those with incomes too high to join the programs — but too low to afford health care — can sign up for Healthy Kids. 

San Mateo and Alameda counties provide universal health care. Contra Costa, Orange and Riverside counties are in the process of creating plans, while Sacramento, Solano, Sonoma, San Joaquin, San Diego and San Bernardino counties are in the discussion phase. Los Angeles was expected to begin discussions soon. 

The counties are increasing outreach, making enrollment simple and quick, and not requiring parents to prove legal residency — something that keeps many from seeking help. 

The drive to get families signed up not only benefits poor families, but also helps counties in the long run. 

“It doesn’t take a whole lot of money for counties to cover these kids relative to the cost of them going into the emergency room,” said Liane Wong, policy director for the Washington, D.C.-based Institute for Health Policy Solutions.