1. Hawaii Ranks 5th-Best Among States in Providing Children's Health Insurance
Hawaii is rated fifth in the nation in making sure children have health insurance, according to a report released today. But that still leaves about 18,000 uninsured children annually, or about 5.8 percent of Hawaii's youngsters, according to the Families USA report, which analyzed data from 2005 to 2007. About 8.6 million children--about one in nine--were uninsured annually during the study period in the 50 states and the District of Columbia.
States with better rates than Hawaii are Massachusetts with 4.6 percent uninsured; Iowa, 5.2 percent; Michigan, 5.5 percent; and Wisconsin, 5.7 percent.
The review period also occurred before the state started the Keiki Care Plan earlier this year to provide health coverage for uninsured children who did not qualify for Medicaid. But the state announced in mid-October that it is dropping the program as a way to save money because of lower-than-expected tax revenues. Ron Pollack, executive director of Families USA, said that even with the demise of the state's Keiki Care Plan, which covered about 2,000 children, Hawaii's earlier efforts to provide children's insurance "has helped put the state in a relatively good position compared to other states." Families USA, an advocacy group of healthcare consumers, wants the new Congress, which convenes in January, to put a priority on reauthorizing the state Children's Health Insurance Program, which expires March 31.
Last year, lawmakers approved expanding the program to about 4 million uninsured children nationally, only to see President Bush veto the legislation. "For the numerous children who count on (the state) Children's Health Insurance Program as their health lifeline, and for the 8.6 million children who are uninsured, support for continuing and expanding (the program) is critically important," Pollack said. "It will determine whether children get the preventive care they need so that they can remain healthy, learn in school and become productive citizens." Pollack also said that because of the economic downturn, Congress is likely to consider providing higher federal matching funds to the states for the Medicaid program as part of an economic stimulus package. That would allow states to expand coverage as more families lose jobs and health insurance.
This measure would help not only those already uninsured but those who are likely to join the ranks of the uninsured due to the state of the economy, Pollack said. Jennifer Sullivan, senior health analyst for Families USA, said that if Congress reauthorizes the program and provides more Medicaid reimbursement, Hawaii might be able to come up with enough money to reinstate the Keiki Care Plan. When the state pulled out of the program, officials said the program might be helping some children whose parents dropped private coverage to get them into the program.
But Sullivan said that children had to be uninsured for six months before they were eligible to enroll in Keiki Care. That should be protecting the state from most parents who drop their children's coverage to get them into the program, she said. "While it may not be on the state's agenda to reinstate the program immediately, we certainly hope that with some additional federal support...they can figure out a way to keep those kids covered," she said. "It would be a shame to be dumping kids off coverage at this point in the (economic) downturn." [Dennis Camire, Honolulu Advertiser, 11/25/08]
2. National: Time To Make Sure All Children Have Health Insurance
The current economic downturn has many faces, including those of children. Economic indicators show that the worst of the recession may be yet to come and many economists are predicting that the unemployment rate will rise to as much as 9 percent next year. If that occurs, approximately 3 million additional children will fall into poverty, with many losing their health insurance.
Even before the impact of the current recession, the last government measurement in 2007 found that nearly 9 million American children are uninsured. Last year the Democratic Congress led by Speaker Nancy Pelosi and Majority Leader Harry Reid passed, and President Bush vetoed, a major expansion of the Children's Health Insurance Program (CHIP) that would have covered 3.8 million of these children by 2012 for about 1 percent of the cost of the recent government financial rescue plan.
Since that time, the need has grown as 1.2 million additional Americans have lost their jobs. Some of these unemployed Americans will not be eligible for any additional assistance to provide health insurance for their children. Others will qualify for Medicaid assistance from the states during their period of unemployment.
But the fiscal situation of states has greatly worsened over the last year, with 41 states showing a combined $72 billion in total budgetary shortfalls. Since most states cannot borrow to meet budgetary gaps, these fiscal problems threaten the health insurance of children and adults alike. In this environment, it is critical that the federal government provide additional assistance to struggling families and states. Failure to do so will lead to large increases in the number of uninsured children or sharp spending cutbacks, which would endanger economic recovery.
Some have argued that an expansion of CHIP would provide too much assistance to families earning more than 200 percent of the poverty line--about $44,000 for a family of four. In areas with high housing costs--such as my district in New York City--families of four at this income level have difficulty paying for the necessities of life. We shouldn't make any family have to choose between basic expenses and health insurance for their kids.
Of course families who can afford to pay for their children's health insurance should be required to pick up part of the cost of coverage. But this issue is a red herring, since uninsured kids are concentrated in low-income families. Two-thirds of uninsured kids are in families below twice the poverty line and more than 80 percent live in families earning below three times the poverty line.
Others argue that CHIP expansion might lead some families to drop their private employer-provided insurance in favor of government coverage for their children. But our decade of experience with the CHIP program shows it's been rare for parents to deliberately drop private coverage to go on CHIP. A recent study by a respected nonpartisan research firm found that less than 15 percent of families on CHIP reported even having the option of private insurance. The private employer-based system requires major reforms. Since the year 2000, the percentage of Americans covered by employer-based health insurance has dropped from 64 to 59 percent. It doesn't make sense to say kids who need help today should rely on the promise of coverage from this broken system.
President-elect Barack Obama and the 111th Congress will make major health-care reform a priority. But we can't wait for large-scale reforms to make sure that no American child is without coverage for their basic medical needs. Guaranteeing health insurance coverage to all of America's children should be put on par with our commitment to all of our seniors through Medicare.
Expanding children's health insurance now is not only good for children and their families, it's also the right medicine for our economy. [Rep. Carolyn Maloney, Times Herald-Record, 12/05/08]
3. South Dakota: No Medicaid Expansion
In his 2010 budget address, South Dakota Governor Mike Rounds vowed to keep Medicaid fully funded so low-income children and families can still receive healthcare assistance, but the governor says two planned expansions of those programs will be eliminated. The first is Title XIX, which would have provided healthcare to roughly 1,268 more low income pregnant women. The other is the State Children's Health Insurance Program (CHIP), which would have provided healthcare to about 2,000 more kids from low-income families. CHIP currently helps roughly 74,000 kids in South Dakota.
"Nothing's worse than having a sick kid that you can't help," said Shari Leveille-Rensch, a mother of four. Shari says CHIP is a lifesaver for her family. She has four children and she and her husband make just $25,000 a year combined, meaning private health insurance is not realistic. "Even with the full-time job that I have, I can't afford to take that money out of my paycheck because I'm just barely paying everything as it is," Shari said.
With two boys on monthly medication, Shari says she's lucky her kids qualify for Medicaid, especially because many people who don't qualify still can't afford all the medications and checkups their kids need. Many of those low-income families that don't qualify, turn to Sioux Falls Community Health for treatment based on a sliding fee depending on their income.
"You know, we're getting more and more demand for our services all the time," says Jill Franken, Assistant Public Health Director for Sioux Falls. Franken says only about 15% of the patients who use Sioux Falls Community Health, actually qualify for CHIP. Governor Rounds says maintaining that coverage is a priority, but expanding it is not an option. "It would have provided health insurance for 2,000 more SD youngsters," Rounds said. "We don't have the money to do it." Shari understands, but says tight budgets are why more people need that coverage. "I'm glad that the people that are covered will still be able to stay covered," she said. "Because, for me, my boys wouldn't be able to have the medicine they need on a monthly basis if I had to pay for it myself. There's just no way."
Governor Rounds proposal to maintain Medicaid coverage in South Dakota will actually require a $19 million increase in state money in order to off-set a shortage of federal funds. [Kent Erdahl, KSFY Television, 12/03/08]
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