1. Hawaii: High School Sports Outreach
Hawaii Covering Kids' partnership with the Hawaii High School Athletic Association enters its fifth year and includes a web site advertisement, full-page tournament program advertisements, kids health insurance banners at tournament venues, other promotional opportunities, and distribution of flyers through athletic directors and trainers.
2. National: Rockefeller Blasts Proposed CHIP Changes in Health Bill
Sen. Jay Rockefeller (D-W.Va.) blasted Senate Finance Chairman Max Baucus (D-Mont.) for considering changes to the Children's Health Insurance Program as part of a broader health care overhaul bill, saying those provisions were a "crime" and "kind of sneaky." Rockefeller, who worked for two years to win support for an expansion of CHIP in February that covers 11 million children, said changes being considered would severely weaken the program. He said he was concerned about proposals to fold CHIP coverage into a proposed health insurance exchange.
"Children have special needs, they have special requirements" that would not be addressed under the legislation, said Rockefeller, a senior member of the Finance Committee. "Their coverage will be much, much, much weaker, and that's a crime." Rockefeller also said proposed bill language that would bar coverage to children of legal immigrants is "kind of sneaky." While Baucus is a major proponent of CHIP, Rockefeller said, the chairman is being swayed by a desire for a bipartisan bill. Baucus wants GOP support, and those Members face tremendous pressure from their leadership not to vote for the legislation without some of those children's provisions in it, he added.
According to Rockefeller, Baucus is "always open to concerns, always open to hearing another view," but the question is what he will do when he gets in a room with the three Republicans helping to negotiate the bill--Sens. Chuck Grassley (Iowa), Finance's ranking member, Mike Enzi (Wyo.) and Olympia Snowe (Maine)--whom he is counting on to support the legislation. A Finance Committee aide disagreed with Rockefeller's assessment. "Chairman Baucus has always been a strong supporter of CHIP and he is fighting to ensure every American child, along with their parents, receive robust, affordable and accessible health care in a reformed system," the aide said.
Children's advocates are also upset that changes to the program could come in the health bill. More than 150 children's rights groups will soon be sending a letter to Members arguing that CHIP should be kept separate from the health care reform bill. "Health reform should not turn back the clock on the progress our nation has achieved for children's health coverage," a copy of the proposed letter says. Bruce Lesley, president of the children's advocacy group First Focus, said Baucus is considering a number of options: keeping CHIP, offering "wrap around" coverage to bridge the gap between what CHIP and the exchange offer, placing children into the exchange and improving CHIP by eliminating eligibility waiting periods.
Lesley and other advocates are concerned that while the CHIP out-of-pocket limit for medical expenses is 5 percent of income, the Senate bill's limit would be 12.5 percent. Advocates are also concerned that there is no option in either the House or Senate bills for child-only insurance policies, which make up 12 percent of all individually purchased policies. Furthermore, various advocates argue that under the current Finance language, children would lose coverage for early periodic screening, diagnosis and treatment services.
Another children's rights advocate summed up the differences, saying, "Nothing really changes in system delivery except a loss of benefits, higher out-of-pocket costs, and less focus on pediatric development." While the groups have been making their case to Baucus, he has not agreed with them, children's rights advocates said. One such advocate said: "Baucus believes children should have the same coverage as their parents. Family coverage certainly trumps if all things are equal, but things aren't equal."
But Lesley believes that backers of CHIP have a "safety net" in an amendment that Rep. Diana DeGette (D-Colo.) included in the Energy and Commerce Committee health care language. Under that amendment, the Health and Human Services secretary would be required to study the difference between the benefits offered by CHIP and the exchange and how to make them comparable. If HHS does not find by December 31, 2011, that the exchange is comparable, children will be removed from the exchange until Congress takes steps to make necessary changes. [Stephen Langel, CongressNow, 08/05/09]
3. Arizona: Bringing Down High Numbers of Uninsured Kids
More than one out of every five children in some counties was without health insurance in 2006, even though they are eligible for nearly free coverage from the state. And the problem seems to be worse in urban versus rural areas. The new report from the U.S. Census Bureau comes as Congress is debating how and whether to ensure more people have access to health insurance. In the meantime, the burden is left to the states. But the most recent figures available, suggest that, even with highly subsidized premiums, children who are eligible aren't getting the coverage to which they are entitled. And a just-enacted premium increase for Arizona's program, known as KidsCare, could make the situation even worse as some parents find the higher costs unaffordable.
Everyone earning below the federal poverty level is entitled to free care from the Arizona Health Care Cost Containment System. That figure is currently $18,310 for a family of three. KidsCare is Arizona's version of CHIP. Enacted by Congress more than a decade ago, it is designed to insure children of the working poor, defined in Arizona as those in families up to twice the federal poverty level. The federal government provides $3 for every $1 of state funds to help provide health insurance. The monthly premium for parents, at least until last month, ranged from $10 to no more than $35.
Dana Naimark, president of the Children's Action Alliance, said she believes the number of children who are eligible but not enrolled is due largely to the lack of knowledge the program exists. And she said some of that blame can be laid at the feet of state lawmakers. In approving KidsCare more than a decade ago, state lawmakers specifically barred AHCCCS, which runs the program, from contracting with schools to help find youngsters who are eligible. "They didn't want more people to enroll," Naimark said. That prohibition has since been repealed. And Jennifer Carusetta, the chief lobbyist for AHCCCS, said her agency even got money to do a six-month outreach program last year. "We've made a lot of progress," Naimark acknowledged. But she said much more needs to be done.
How much progress is less clear. In June 2006--the time period in the Census Bureau report--there were 58,609 children enrolled in KidsCare. As of this past June, that number had dropped to 53,408. Carusetta said that could reflect the recession: As more wage-earners lose their jobs, they become eligible for the regular AHCCCS program which covers all families members without cost. But Naimark said many people don't realize they can get nearly free care for their children. "These are people who are working," she said. "They've never been on welfare," Naimark continued, and are ineligible for AHCCCS. "They just don't think there's something out there for them." And she said they won't learn about KidsCare unless the information is available at places they normally go. "We have not had a sustained effort like that in Arizona," Naimark said. "We've had stops and starts."
Carusetta said her agency was still reviewing the figures to see what conclusions could be drawn about why there are so many children who could be getting health insurance through KidsCare but are not enrolled. One issue, she said, is that parents may not be able to afford the premiums. Those in the lowest end of eligibility, those with incomes between 100 percent and 150 percent of the federal poverty level, pay $10 a month to enroll one child and $15 for two or more. That has not changed. But those between 175 and 200 percent of the poverty level saw their premiums double in June, to $50 a month for a single child and $75 for multiple children. She also said some children may not be able to meet the requirement to be citizens or legal residents.
Naimark said she believes many of the children are, in fact, here legally, though their parents may be illegal immigrants. She said there is likely a fear factor of those parents to apply for the services to which their children are entitled. Finally, Carusetta said, there is the question of choice. "You can't force a person to fill out an application," she said. [Howard Fischer, Capitol Media Services, 08/04/09]
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