1. More Children Without Health Insurance in New York
More children are going without health insurance in New York State. That's according to a report being released by the Children's Defense Fund of New York. The report claims that the number of uninsured children and teens in the state went up by 61,000 last year. That's a 17-percent increase over 2004, according to the most recent census data. The group says a total of 415,000 young people were living without insurance in New York in 2005. [Capital News 9, 11/14/2006]
2. Minnesota: First Health Care Hurdle? Paperwork
It's open enrollment season for a lot of us who get our health coverage at work, the time of year when we grumble about how much our premiums and co-pays have risen and wonder why we have to provide so many receipts to get access to the cash in our own inflexible spending accounts. Of course, if you think you've got a headache with your health care paperwork, just try applying for coverage through one of Minnesota's public health plans.
In recent years, the application for health care assistance has metastasized from four pages to a 36-page file I downloaded this week from the Internet. Included in this count are the expected questions about how many people are in your family, where you're from and where you work. Applicants also must document more personal details, such as assets and income, the cost of one's car and whether they have any plans to buy or sell real estate. They even have to explain whether any household member has already paid money for a burial contract with a funeral home, attaching all related receipts and terms with an estimate of the contract's value. Looking at this application, it's little wonder that research has shown "administrative hassles" to be the primary reason parents don't enroll their eligible children in public health programs. It's one of the many barriers to health care that the new and improved Tim Pawlenty must move aside for Minnesota families if he wants to create universal health coverage for kids, a campaign promise he waited until after the election to reveal.
Universal health coverage for children is a great cause for a fiscal conservative like Pawlenty, even if the Democrats have been the folks harping on about it for the last two sessions. Though Minnesota enjoys one of the lowest rates of uninsured citizens in the country, the number of kids without coverage jumped from 56,000 in 2001 to 68,000 by 2004--a number the Children's Defense Fund Minnesota notes is equal to all the kids living in Moorhead, Duluth, St. Cloud, Stillwater, Mankato and Rochester combined.
An estimated 27,000 of these uninsured Minnesotans are younger than 6, a critical time in child development, when wellness visits chart important milestones and check off critical immunizations. The costs of not keeping up to date with the doctor can rack up quickly. Kids with no insurance are more likely to develop eye and ear infections, lead poisoning, and such chronic conditions as asthma and diabetes. Uninsured children are nine times as likely as their peers not to have a regular doctor or pediatrician who has seen them before, five times as likely to have an unmet need for medical care, and four times as likely to have used the emergency room.
"It's maybe penny-wise not to (pay for coverage), but ultimately pound-foolish that kids without care end up going to the emergency room," says Marc Kimball, communications director of the Children's Defense Fund Minnesota. Last spring, the group released a report called "The Road Not Traveled," which made a compelling case for universal children's health care in the state. (You can read more by visiting www.cdf-mn.org.) One of its most convincing arguments came in the form of a chart showing the average cost of paying for a year of medical assistance for one child (less than $3,000), compared to a hospitalization charge for bronchitis and asthma (just under $6,000), compared to the hospitalization charge for pneumonia ($12,000).
Clearly, preventive care for our kids is the better investment. The Minnesota Department of Health and the University of Minnesota School of Public Health estimate that more than three out of four uninsured children in the state are eligible for a public health care coverage program, but are, according to the CDF report, "unable to access it for one reason or another." Streamlining the 36-page application process might be an easy place to start reducing those hurdles to health care, and improving the health of Minnesota's kids. It could even improve the health of Minnesota's forests. [Laura Billings, TwinCities.com Pioneer Press, 11/16/06]
3. Kentucky: Health Care for All Children
Now that one of the most divisive political campaigns in history is finally over, the nation's elected officials have the opportunity to work together across party lines to accomplish a goal that a majority of Americans supports: making sure that all the nation's children have the health care they need. The challenge is inescapable, and the solution is achievable. Over 75,000 children in Kentucky and nearly 9 million children across America are growing up in households without health insurance. As healthcare costs continue to rise and more companies cut back or cut out their medical plans for their employees and their families, more children are likely to lose their health insurance.
While public figures frequently say that our children are our future, they need to give serious thought to the futures of children growing up without medical care. These children's parents think twice before taking them to the doctor when they're ill or injured. They can't afford regular medical checkups, so they take them to emergency rooms when small problems that weren't attended to early become big problems that require immediate assistance. They often develop serious health problems, from rheumatic fever to difficulties with vision or hearing, that go untreated and trouble them for the rest of their lives.
Providing children with health coverage is politically possible and fiscally feasible. Public opinion surveys consistently demonstrate that Americans across the political spectrum believe that children should have medical coverage so that they can grow up healthy, succeed in school and become productive citizens. While fixing the nation's entire healthcare system may seem overwhelmingly complex and costly, providing health insurance for all of America's children is a goal that the nation can achieve and afford.
The blueprint is simple: Build on the gains that have already been made by two proven programs that provide health care for kids from low-income families. Serving the nation's low-income families, Medicaid provides health care for 28 million children nationally and more than 300,000 children in Kentucky. Meanwhile, another effort--the State Children's Health Insurance Program (CHIP)--has been one of the greatest recent social policy successes. Created in 1997, federal CHIP funds support states to provide health insurance for children who are not insured already.
Currently, the program covers more than 6 million children, most of whom would otherwise be uninsured. Kentucky's program--KCHIP--covers more than 50,000 children. CHIP's success can be measured by the fact that, since 1997, the percentage of children from low-income families without [health] insurance has declined by one-third, despite the fact that millions more adults have lost their medical coverage.
These gains could be reversed unless the newly elected Congress continues to work with state governments to maintain and expand health coverage for youngsters in need. As healthcare costs increase and the nation's population grows, Medicaid services for eligible children should continue to be guaranteed. Meanwhile, CHIP's original 10-year authorization expires next year. This is an opportunity for elected officials to ensure children continue to receive care and more children have access to health coverage.
Meeting this challenge requires bipartisanship and bold action, nationally and in the commonwealth. Congress needs to guarantee that Medicaid services for children continue to be available and that CHIP is maintained and improved so it can provide better services for more eligible children. Kentucky should follow the lead of Pennsylvania and Illinois, which recently expanded their own efforts to provide health care to children in need. Now more than ever, America's children need to grow up ready to succeed as parents and as citizens in school and at work. If we want to raise a generation of young people who are prepared to meet their obligations, then our nation's leaders must fulfill their own responsibility to see and solve the problem of millions of children coming of age without the health care they need. [Terry Brooks, The Courier-Journal, 11/17/06]
4. Virginia: Rules Deter Poor Children from Enrolling in Medicaid; Needed Documents Unavailable to Some Families Officials Say
Thousands of low-income children have been unable to enroll in Virginia's Medicaid program since July 1 because of new, tougher federal rules requiring proof of citizenship and identity, state officials said. Officials for the state program for the poor and disabled said as many as 10,000 eligible children are living without health care largely because their families have been unable to present original birth certificates and other needed documentation to state or local Medicaid officials.
"These new rules are the single greatest factor for why children haven't been able to enroll" in Medicaid, said Linda Nablo, director of Maternal and Child Health at Virginia's Department of Medical Assistance Services, who said exact numbers would be available by the end of the month. "There are cases where everything about them is done, everything about them is approved, and all we're waiting for is [citizenship and identity] documentation. "In the meantime, these kids are going without health care," she added.
The new federal rules, designed to curb fraud by illegal immigrants, require passports, birth certificates or other identifying documents to be shown when people apply for Medicaid benefits or during annual reenrollment in the program. Parents are also required to offer sworn affidavits as proof of a child's identity.
The rule is part of last year's Deficit Reduction Act, which President Bush signed into law in February. Despite a federal inspector general's report concluding that there was little fraud by illegal immigrants, supporters said the measure would ensure that Medicaid dollars go only to citizens or eligible immigrants. Previously, Medicaid applicants declared their citizenship or legal status, under penalty of perjury, without having to show evidence, although some states demanded proof. After an outcry from health care advocates across the country, federal officials exempted elderly and disabled applicants from the new regulations. But the same exemption was not given to most children, which state officials say is making it difficult to enroll minors.
"We're talking about families that don't have a lot of resources," said Shelby Gonzales, director of Partnership for Healthier Kids, a Fairfax County program run by Inova Health System. She and other advocates said families are showing up at social services departments looking for medical coverage but never follow through because of the extra layer of bureaucracy. "There are just a lot of practical reasons why it's been difficult," she said.
State officials said that adults eligible for Medicaid might also be experiencing difficulties enrolling in the program but that it is unclear how many. Medicaid spokeswoman Mary Kahn said the federal Centers for Medicare and Medicaid Services has done everything it could to prepare low-income families under the parameters set by federal lawmakers. "Of course we're concerned that children who are entitled to health care may not be receiving it because of any misunderstanding about the new rules," she said. "We're working within the parameters that Congress gave us to assure that the goals of the law are met while not excluding people who are legitimately entitled."
Thus far, the changes have only affected those who are seeking health care benefits for the first time, state officials said. Like most states, Virginia gave those already enrolled several months to gather the necessary documents. But that grace period ends this month, and there is concern that people who can't come up with the documents will be kicked out of the program.
"This is the tip of the iceberg," said Jill Hanken, a staff attorney for the Virginia Poverty Law Center in Richmond, which has been tracking the impact of the new regulations. "Once the grace period is up, unless we see a change, there are going to be a lot of people who simply won't be able to get reauthorized." Officials in Maryland said they have not been able to determine whether any children have been unable to receive health care, largely because they only recently started tracking changes. Officials in the District [of Columbia] reported that the number of children enrolling has not dropped.
Virginia officials and advocates for the poor said the new rules have stymied much of the progress the state has made in enrolling children in the state health care program. Over the past several years, Virginia has averaged a net increase of 1,700 children a month into the Family Access to Medical Insurance Security Plus program; since July it has averaged a net loss of about 3,500 a month. As of Oct. 1, there were 376,314 children on Medicaid in the state. [Chris L. Jenkins, Washington Post, 10/08/06]
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