1. Connecticut: Pointless Paperwork Is a Health Care Hurdle
For many Americans, tax day is an annual reminder of the hassles of filling out government forms, but for millions of low-income families who must continually apply for means-tested programs these headaches are an everyday reality. As a student health outreach volunteer in Connecticut, I have had firsthand experience with all the hassles of HUSKY, the state's children's health insurance program. Not only is the six-page application inordinately complex, but even after families are enrolled, they have to send in the same information again and again to maintain their coverage. Consequently, thousands get lost in the system: nearly half of the 35,000 low-income, uninsured children in Connecticut were previously enrolled in HUSKY but then lost coverage because of problems with their renewal paperwork.
Frustrated by all this bureaucracy, I decided to take a closer look at the fine print on the last page of the HUSKY application and I found, to my surprise, that the state already knows who is eligible. All that information that we enter each year on our tax forms, all the automatic withholding on our wage stubs and all the data we enter at the Department of Motor Vehicles are part of a secure data system that states have been using for years to verify eligibility in public programs. The paper forms and bureaucratic barriers are just an obstacle course for families to show that they really do want coverage.
Now, I have never met parents who didn't want health care for their child, so I asked the next logical question: Why doesn't the government use all this existing information to automatically enroll eligible families in public programs? Findings from behavioral economics suggest that opt-out policies are much more effective than opt-in ones. This strategy has long been used successfully for Medicare Part B to give senior citizens the benefits they deserve. Some policy-makers may say that they cannot afford to pay for the millions of uninsured Americans who are already eligible for public health insurance programs. But as I dug deeper, I found that all the administration and paperwork for means-tested programs cost taxpayers tens of billions of dollars a year. States that have reduced the need for application forms have been able to cut enrollment costs by more than half, which allows more taxpayer money to go directly to families in need. [Robert Nelb, The Hartford Courant, 4/15/09]
2. National: Say Ahhh! Children's Health Policy Blog
Center for Children and Families has leapt into the blogosphere by launching "Say Ahhh! A Children's Health Policy Blog." With the rapidly shifting dynamic in the health policy world and an unpredictable economic environment, "Say Ahhh!" will provide a good meeting place to share ideas, find solutions, and keep up with new developments. This is an exciting time for health policy at both the federal and state levels for people to share insights on healthcare policy. [04/16/09]
3. Western USA: Let's Remember the Children
As dollars from the Economic Stimulus Act arrive here in the eight Rocky Mountain states, most Westerners seem to be talking about spending that money on shovel-ready jobs. The projects we hear about are intended to repair our crumbling schools, bridges, roads and sewers, or to restore our abused landscape. We know, too, that money is being made available to protect current jobs likely to be lost without federal help. On the whole, I think that the President and the Congress are attempting, once again, to be a valued partner in one of our nation's most difficult times.
But there's something else to consider that's even more basic: health care for children. As legislators and governors out our way consider the appropriate uses of these public dollars, they would do well to realize that the competitiveness of the Rocky Mountain West is being undermined because working families--including 1 million of their children--have no health insurance.
In fact, six states in the Rocky Mountains have the highest percentage of uninsured children in America. That means that Western families with children suffer the worst healthcare coverage in the world--unless, of course, we want to compare ourselves with a few impoverished, war-ridden disaster zones in places such as sub-Saharan Africa. We Westerners consider ourselves a caring and large-minded people. Well, insuring our families--and particularly our kids--is not only a matter of principle, it has now become an economic imperative: Uninsured families can rapidly sink into bankruptcy from a single child's health emergency. Health insurance for our children thus becomes a sound investment because it avoids dependence on expensive emergency-room care, provides preventive care and helps to avoid a lifetime of unnecessary illnesses.
Meanwhile, the current economic mess, including the lack of healthcare insurance, is stifling the economy of the Rockies. You can see the impacts in drained savings accounts, lost mortgages, hospital closures in our rural areas, overly burdensome insurance premiums, lost profits and productivity for our critical small businesses, and, of course, enormously costly private insurance. It is estimated that our states could save an average of $2,100 per child each year if health care were provided, compared with the current non-system, which shifts costs to those of us who have insurance as well as passing it to the region's seriously strapped health care providers. And always in the rural West, small towns get hit the hardest.
Because the West has mostly small businesses, a large percentage of working families have no employer-provided insurance. Nationally, 4 percent of people who have insurance pay the entire cost; in the Rocky Mountain West that number has soared to 7 percent. The rising cost of health care and thus insurance has caused a significant erosion in the proportion of Western working families able to obtain coverage through an employer. Montana, Wyoming, New Mexico and Colorado are among the 10 states in the nation experiencing the sharpest declines in private insurance coverage for our kids.
Many states continue to try to alleviate the problem, but of the 18 states to extend what is known as the State Children's Health Insurance Program (CHIP) to more low and some middle-income families, not one is in the Rocky Mountain West. Montana voted to do so in the past general election, but conservatives in the current Montana Legislature are trying to renege on that overwhelming public mandate. Those conservatives forget that CHIP was once considered a nonpartisan policy: It was written by Utah Republican Sen. Orrin Hatch and Massachusetts Democrat Sen. Ted Kennedy. There have been recent attempts to help more children: In 2007, the House of Representatives and Senate twice passed healthcare coverage for several million children; both times the bills were vetoed.
Spurred by last November's elections, our government is trying to right the wrongs of the last decade and a half. With this new stimulus package made available by President Obama and the Congress, the states will at last get additional dollars that can be used to insure our children. The Rocky Mountain states have been slow on this issue. Now, this region has the chance to strengthen families by channeling some of this new money toward children who need it. [Pat Williams, High Country News, 04/07/09]
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