1. National: HHS Secretary Opens National Children's Health Insurance Summit U. S. Department of Health & Human Secretary Kathleen Sebelius called on states and communities to join with DHHS and redouble efforts to find and enroll the five million children who are currently eligible for Medicaid or Children's Health Insurance Program (CHIP), but are not yet covered. The secretary issued this call to action as she opened the National Children's Health Insurance Summit in Chicago, kicking off the nation's largest campaign to find and enroll uninsured children in over a decade. Much progress has been made in recent years, but the enactment of the Children's Health Insurance Reauthorization Act (CHIPRA) creates new opportunities to move forward. At the same time, given the economic downturn, the need among families for affordable coverage for their children could not be greater. Not since CHIP's creation in 1997 has the federal government, in conjunction with states, concentrated so many resources on the effort to find and enroll children who needlessly go without health insurance. "As a society and as parents, we have no greater responsibility than to provide quality health care for our children," Secretary Sebelius said. "Our charge here today is to get all eligible children covered to ensure they are healthy throughout their childhood. A healthful child is the block upon which all other successes are built, not just for the child, but for the nation they will lead in the future." In February, President Obama signed CHIPRA into law. The legislation fully funds CHIP over the next four years and devotes an unprecedented amount of federal funding to support outreach and enrollment efforts for both CHIP and Medicaid. Currently, Medicaid serves more than 32 million low-income American children while CHIP has over 7 million recipients. The speech launched a three-day conference in Chicago sponsored by the Centers for Medicare & Medicaid Services (CMS) that brought together state Medicaid and CHIP officials, local government representatives, community-based organizations, safety-net providers, and others who work to promote enrollment in children's health insurance programs. These experts exchange proven strategies for finding and enrolling children in health programs as well as removing barriers that sometimes prevent children from staying in these programs despite continued eligibility. Conference participants also heard from experts on a wide range of specialized topics, such as reaching diverse or isolated populations, the usefulness of online applications, and how to best work with managed care plans and other health care providers. Also attending the conference were grantees from 69 organizations across the country that were awarded $40 million by HHS to fund outreach projects in their local communities. Over the next four years, HHS will award a total of $90 million in outreach grants. "With the nation's unemployment rate at a staggering 10.2 percent and families losing their job-related health insurance, finding and enrolling eligible children could never be more important," said Cindy Mann, director of the Center for Medicaid and State Operations within CMS. "Bringing together government officials, tribal leaders, community organizations, and policy experts will build on the successes achieved in recent years and lead to fresh, innovative, and successful strategies to deliver quality health care to every eligible child in America." [HHS News Release. 11/04/09] 2. National: Uninsured Children Have Higher All-Cause In-Hospital Mortality In case you needed it, here's another reason why children's health insurance is important. A recent study from Johns Hopkins found that children who enter the hospital uninsured are more likely to die than those who have coverage. In fact, uninsured children were found to have an in-hospital mortality rate 60% higher than their insured counterparts. Extrapolating their findings (and assuming that lack of insurance was the driving factor), the researchers estimate that approximately 17,000 in-hospital deaths may have been prevented over the last 18 years if these children were covered. An interesting conclusion suggested by the paper is that these children were sicker before they were admitted. The rationale--uninsured children who died during their hospital stay were in the hospital for a shorter amount of time and the charges for their care were significantly lower. The authors propose that the uninsured children presented with more serious cases and, in many circumstances, it was simply too late to intervene. This study adds to a long list of research showing the importance of health insurance, including findings that uninsured children are less likely to receive immunizations, prescription medications, asthma care, and basic dental care. Others have found that children who have health insurance miss fewer days of school and have fewer avoidable hospitalizations. Importantly, they also tend to receive more timely diagnoses of serious health conditions, a point that this study seems to validate. [Martha Heberlein, "Say Ahhh!" Children's Health Policy Blog, 11/05/09] 3. Kentucky: State Expects to Meet Children's Enrollment Goal Six Months Early State officials said they are on target to enroll 35,000 children in two key public health insurance programs by the end of 2009, six months ahead of schedule. In November 2008, Gov. Steve Beshear pledged to increase the number of children in Kentucky Children's Health Insurance Program (KCHIP) and Medicaid programs by decreasing some of the road blocks to the government health insurance program for low-income families. Currently, there are 32,000 new children enrolled in the two programs, Beshear said. But both programs combined have enrolled on average 2,600 children a month. Current rates indicate that the Cabinet for Health and Family Services, which oversees the health insurance programs, will meet the 35,000 goal by December instead of June 2010, as originally projected. KCHIP was designed to provide health insurance to children whose parents made too much money to qualify for Medicaid. It provides insurance to families whose income is below 200 percent of the federal poverty level, or about $44,100 a year for a family of four. Medicaid's income eligibility guidelines are lower. Cabinet officials said that most of the increase in new enrollees over the past year has been in the state's Medicaid program. Beshear credited a push by the cabinet and various community groups to increase awareness and also increase training for health care and other professionals who may come in contact with families who do not have health insurance. Applications for the programs are now available online and, more importantly, families who apply no longer have to have face-to-face interviews to apply. But Beshear noted that the economic downturn also contributed to the up-tick in the number of new children in the program. "The state of our economy is reflected in these new numbers," Beshear said. Many Kentuckians are losing their jobs and some are losing their homes. Access to quality, affordable health care is increasingly becoming a concern to families all across this Commonwealth. Janie Miller, Secretary for the Cabinet for Health and Family Services, said the increase in the number of children in the health insurance programs has cost the state about $19 million. Most of the cost of the two programs is paid for by the federal government. "We were able to absorb the cost in our existing budget," Miller said. The state also received an increase in its Medicaid funding because of Kentucky's high unemployment rate. Those additional dollars will help defray some of the costs, Miller said. The state saw an increase in the number of applications for the health programs when school started in the fall. The cabinet also increased its awareness campaign after a nonprofit group released a report in July of a survey of Anderson County health care providers. Many of those providers did not know the difference between Medicaid and KCHIP. The report said that the cabinet needed to do more to spread the word about KCHIP. Terry Brooks, executive director of Kentucky Youth Advocates, a nonprofit based in Louisville, said social service groups had pushed for years for the cabinet to drop the requirement of in-person interviews because too many working families didn't have time for them. The Beshear administration finally listened, Brooks said. As a result, more Kentucky children have health insurance than last year. "You would have to line up 600 school buses to fit in all the new enrollees," Brooks said. [Beth Musgrave, Lexington Herald Leader, 11/02/09]