Children's Defense Fund

CHILD WATCH? COLUMN

 

Children's health insurance: stories from the field

 

By Marian Wright Edelman

Vivian is a lively and beautiful two-year-old with cute pigtails, contagious laughter, and a charming smile.  When you look at her, you'd never know how hard it is sometimes for her to breathe.  You see, Vivian has chronic respiratory problems, including asthma.  A mild attack leaves her coughing and gasping for air.  A serious attack leaves her feeling like she is suffocating.  If she doesn’t have the tools to manage her asthma--like an inhaler--or if she doesn’t receive prompt treatment in the case of a serious attack, her life could very well be in danger.

Another thing you can’t tell about Vivian when you look at her is that she has doesn’t have health insurance.  Her father works full-time delivering linens and earns about $550 a week.  But his job doesn’t offer health insurance, and private health coverage for their family would cost about $900 a month—nearly two full paychecks, and clearly out of their reach.  Vivian used to receive coverage through the Children's Health Insurance Program (CHIP).  She was enrolled in CHIP when she had to be hospitalized for ten days for serious pneumonia—the medications cost $100 apiece, which the family never could have afforded otherwise.  But then her father received some commissions that put the family's income above the CHIP limit by $37.  As a result, Vivian lost her coverage. 

Kim was one of 300,000 New Orleans residents who came to Houston after fleeing Hurricane Katrina.  Along with losing her home and belongings, she also lost health coverage for her two sons, ages three and 11.  The children used to be covered by the Louisiana CHIP program, but their health coverage didn’t transfer across state lines.  Kim has been trying for months to get the children enrolled in the Texas CHIP Program without success.  It took her weeks to learn her original application was considered incomplete.  One of the missing documents she has been asked to submit is a copy of a child support order from the New Orleans court.  The court hasn’t reopened since the storm so she hasn’t been able to get the form.  Meanwhile, the children continue to go without health coverage nearly a year later.

Lorna is a single mother and small business owner who can’t afford private health coverage either.  Lorna's nine-year-old son has asthma, allergies, and serious mental health needs.  Lorna’s son should also be covered by the Texas CHIP program, but because of an error made by the new private contractor Texas is using to administer CHIP,  he was one of 24,000 children mistakenly denied benefits when their coverage came up for renewal.  Although Lorna submitted the required documentation, the state continued asking for "missing information," including her son’s income level.  It was only when her state representative intervened on her behalf that her son's health coverage was reinstated.

These three families are all experiencing the stress that comes with being uninsured--and trying to worry about monitoring their children’s health and finding money for care at the same time.  Fighting state bureaucratic problems and errors only makes this stress worse, and the emotional and financial costs are both far too high.  If you know someone who is uninsured, or if you are uninsured yourself, then you’ve seen firsthand the personal consequences of not having access to health care.  But many people don’t realize that having high numbers of uninsured people affects everyone.

 For example, the state of Texas, where all three of these families currently live, receives $2.63 in federal matching funds for every $1 of state funds invested in CHIP, and $1.54 for every $1 invested in Medicaid.  But when working families lose CHIP and Medicaid coverage and return to city and county health clinics for care, as is happening with these families, local taxpayers absorb 100% of the costs.  Cuts to preventive care also put additional strain on already overcrowded emergency rooms, and emergency room treatment is far more costly than preventive investment.  According to the Harris County Hospital District in Houston, the cost of preventive treatment for an established patient’s mild asthma attack in a local doctor’s office would be $94 to $103 using oxygen or a nebulizer and medicines.  But if a child like Vivian goes untreated and eventually winds up in the emergency room with full symptoms and needs to be hospitalized for three days, the average stay for a serious asthma attack, the cost is $9,209.   It doesn’t take much math to figure out that taxpayers and uninsured children are both losers.

We know there’s got to be a better way.  CDF is developing a campaign to enact comprehensive health insurance coverage for all children now.  To sign our Call to Conscience and Action and send a message to your elected officials telling them we can and must do better in protecting the health and wellbeing of all our children visit www.childrensdefense.org.

Marian Wright Edelman is President and Founder of the Children's Defense Fund and its Action Council whose Leave No Child Behind? mission is to ensure every child a Healthy Start, a Head Start, a Fair Start, a Safe Start, and a Moral Start in life and successful passage to adulthood with the help of caring families and communities.

 

 

 

 

 

 

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