1. Young Adults: A Growing Proportion of the Uninsured Young adults ages 19-29 are twice as likely to be uninsured as children or older adults. Lack of insurance jeopardizes the health of young adults, especially those with low incomes. Over the past decade, the proportion of young adults without health coverage has risen from 22 to 30 percents, despite a tight labor market. Many forgo preventive health care and say they would "wait as long as possible" to seek treatment when sick. A news release including a link to the full report can be found at: 12 Million Young Adults Lack Health Insurance: Double the Rate for Older Americans . 2. Expanding Medicaid to Cover the Uninsured As states reexamine how Medicaid could provide a health insurance safety net for the working poor, the Spring 2000 edition of States of Health by the group Community Catalyst explores the Medicaid expansion strategies some states are using to provide health coverage for the working uninsured. Expansion examples from Wisconsin, Rhode Island, and New York are featured, as well as a discussion of a use of tobacco settlement funds to help create a Medicaid expansion. The publication summarizes studies by the American College of Physicians-American Society of Internal Medicine, the Kaiser Project on Incremental Health Reform, and Columbia University, prominently features the comment that Medicaid expansions are an effective way to reach low-income uninsured working adults, particularly working parents whose children may qualify for CHIP or Medicaid. Also featured in the report is a study implying that the national push to insure children via CHIP may not achieve all its goals unless parents are also offered health insurance because a mother's access to health care was found to be the single strongest factor in determining a child's access. Copies and further information about States of Health can be found by calling 617-338-6035. 3. Studies Examine Immigration and Minority Health CA Healthline, 18 July 2000: Immigrants and their children comprise 59% of the growth in the uninsured population since 1993, the study asserts, adding that the uninsured population could grow by three or four million over the next ten years if immigration rates remain unchecked. Currently, immigrant and their children, most residing in the United States legally, comprise more than 25% of the nation's uninsured. In addition, the report found that 26% of the nation's uninsured live in households headed by an immigrant. Further, immigrants in households earning more than $75,000 annually tend to have lower rates of health coverage than their native-born counterparts. Another study, funded by The Robert Wood Johnson Foundation and published in the July/August issue of Health Affairs, disputes that immigrants are contributing to the rising ranks of the uninsured, maintaining that legal immigrants "use fewer medical services than the general population." The study also concludes that most immigrants come to the United States for jobs or to live with family members, not because of government health programs. The study notes that "restricting illegal immigrants already in the United States from government health care programs is not likely to reduce the level of immigration" (Appleby, USA Today, 7/18). 4. Demographic Differences in CHIP and Medicaid Children Calls for Different Outreach Strategies With relatively healthier children and somewhat higher, but still limited incomes, families eligible for State Children's Health Insurance Plans may be put off by the stigma of public health insurance and not reached by traditional Medicaid outreach strategies, according to a July article in Pediatrics. Read a summary by the Health and Health Care in School Report. http://www.gwu.edu 5. HHS Releases Report Calling for More School-Based Outreach for CHIP and Medicaid July 10--At the request of the President, Department of Health and Human Services Secretary Donna Shalala has released a report outlining how states can more efficiently use schools and early childhood programs to conduct outreach and enroll children in the State Children's Health Insurance Program (CHIP) or Medicaid. Stating that there are still millions of children who are eligible for CHIP and Medicaid and must be enrolled, the report says that states must work past the barriers to enrollment, which include parents' lack of knowledge of insurance options, cultural and language barriers, and complicated application and enrollment procedures. The Secretary recommends that more outreach can and should be done through schools and early childhood programs, calling them the "critical link," to get the word out to parents about CHIP and Medicaid. The report provides a federal strategy to assist states in these efforts. Among the recommendations, the Secretary suggests that the Federal government: * facilitate coordinated enrollment activities between Medicaid, CHIP, and other public programs with similar eligibility criteria; * provide technical assistance and support to help states, communities, and health care providers and schools implement school-based outreach and enrollment activities for Medicaid and CHIP; and * encourage new or additional school-based outreach and enrollment efforts by helping states and schools identify and maximize funding opportunities. The Secretary's report also outlines "promising state practices," innovative efforts that have already been initiated in various schools across the country, to serve as models for other schools. To download the full report in PDF format, click here: http://cms.hhs.gov/schip/sbo600.pdf. 6. New York City Mayor Announces Innovative Plan to Bring Health Insurance to More Children In an effort to reduce the number of uninsured New Yorkers and increase their access to health care, Mayor Guiliani and the City of New York have announced an innovative approach to use computer systems and city agencies to identify and enroll uninsured children and adults in health insurance programs. The scale of this endeavor for a city is unprecedented and should serve as a model for other urban cities in the U.S. seeking to address this issue. The program, called Health*STAT 2000 and announced on June 14, 2000, is initially focused on enrolling uninsured children in the New York's State Children's Health Insurance Program (CHIP): Child Health Plus and Medicaid, depending on which program they qualify for. According to the City of New York's estimates, there are close to 1.5 million low-income city residents who lack health insurance and close to 900,000 of them who are eligible for federal and state health care plans. One-fourth of those are children while two-thirds of those are working, either full-or part-time. "Expanding access to health insurance is one of the most important ways the City can improve the lives of New Yorkers," said Mayor Guiliani at a press conference unveiling the program. "...For the first time, the City is focusing all its available resources on providing as many people as possible with health insurance." Health*STAT is modeled after the Mayor's anticrime initiative, Comp*STAT, and will divide the city into eight regions, each run by a manager, and will use statistical information to identify areas with high concentrations of uninsured children and adults eligible for public health insurance programs. Based on those results, city workers will be placed in facilities in those areas, such as police stations, firehouses, and schools, to recruit families to apply and enroll their children in Child Health Plus or Medicaid, New York City's CHIP Programs. The managers and other participants will monitor the initiative's progress at weekly meetings. Another key objective of Health*STAT is to increase the accessibility of private health insurance to small businesses, where cost is often an obstacle. At the press conference, the Mayor announced the creation of HealthPass, a health care purchasing alliance that increases the number of private plans available for small businesses, as well as Healthy New York, a state program of subsidized health insurance for small businesses. The City will also seek to enroll eligible uninsured adults with the recently created Family Health Plus state initiative that will increase income eligibility for adults for Medicaid, in 2001.