Philadelphia: New push for children's health insurance

[Harold Schiffman]

New push for child insurance
By Alfred Lubrano

Inquirer Staff Writer

Anxious but hopeful, those who work with the poor and the working poor
are awaiting the Obama administration's first moves on behalf of the
disenfranchised.
The State Children's Health Insurance Program (SCHIP) is among the new
president's top priorities. That's welcome news, advocates say, as
more people lose jobs and health insurance in a worsening economy.

Created using Pennsylvania's state-run CHIP program as a model, SCHIP
provides states with federal money to cover uninsured children up to
age 18 in families with income above Medicaid eligibility levels but
who cannot afford health insurance.

Bipartisan bills to increase SCHIP funding were twice passed by
Congress and twice vetoed by President George W. Bush, though 80
percent of Americans supported the legislation, according to various
polls. Funding for the SCHIP program ends on March 31.

The House of Representatives passed a bill on Jan. 14 that would take
the program from $167 million a year to $312.5 million in each of four
years, an 87 percent increase.

The Senate has taken up the bill, and until a debate erupted
yesterday, legislators hoped to have new SCHIP legislation on Obama's
desk in a few weeks.

When it finally gets hammered out, "the president will sign it," U.S.
Sen. Bob Casey (D., Pa.) said in an interview earlier in the week.
Casey is known for his work on poverty issues and is considered a
friend of the president.

"I had trouble understanding why Bush voted against it. It was
ridiculous. This is a wildly successful government program that works
with private insurers to give children coverage."

Casey is especially tied to SCHIP because his father, Gov. Bob Casey,
was one of the program's creators in Pennsylvania in 1992. It became a
national program in 1997.

Trouble in the Senate cropped up yesterday as Republicans bristled at
changes Democrats made in the newest version of the SCHIP bill.

Democrats want to eliminate a five-year waiting period for new
legal-immigrant children to enroll in the program (Pennsylvania has no
such requirement). Also, identity and income requirements would be
loosened. Republicans have vowed to fight those measures.

Until yesterday, the SCHIP legislation had few known detractors,
according to Peter Adams, deputy insurance commissioner for CHIP with
the Pennsylvania Insurance Department.

In the past, some said they were concerned that the program moved the
government into the insurance business. That was one of Bush's
worries.

But the insurance is through private companies, and the program is
paid for by tobacco taxes, Adams said. The federal government pays for
two-thirds of the cost in Pennsylvania. The state puts up the rest,
much of it from tobacco taxes, according to Ann Bacharach, special
projects director of the Pennsylvania Health Law Project.

The legislation comes at an important moment, said Adams, whose
department will release a report tomorrow showing that the number of
people with private insurance decreased 4 percent in the state between
2004 and 2008. At the same time, the number of people on Medicaid and
CHIP increased by 4 percent.

The nonprofit advocacy group Public Citizens for Children and Youth in
Philadelphia says there has been a 40 percent increase in calls from
parents needing help to pay for their children's health insurance over
the last year.

"We are talking to families who never thought they'd need a safety net
before," said Colleen McCauley Brown, director of health policy for
PCCY.

Currently, there are 183,891 children in Pennsylvania's CHIP, up 11
percent from a year ago, Adams said.

In Philadelphia, CHIP enrollment increased from 26,611 in October 2008
to 28,273 this month, according to figures provided by Cathleen Palm,
a statewide child advocate.

Blame the economy for the increases, she said.

In that same time frame, CHIP enrollment went from 7,753 to 7,984 in
Bucks County; 5,170 to 5,355 in Chester County; 7,793 to 8,151 in
Delaware County; and 8,502 to 8,732 in Montgomery County.

There are about 90,000 uninsured children in the state who are
eligible for CHIP aid but are not receiving it, Adams said.

Many of these children's parents have never heard of CHIP, are
suspicious of a government program, or experience language barriers,
said Sharon Ward, director of the Pennsylvania Budget and Policy
Center in Harrisburg.

In New Jersey, there are 129,000 children enrolled in the state's
version of CHIP. But there are 300,000 uninsured children, according
to Ray Castro, SCHIP expert with New Jersey Policy Perspective, a
nonprofit research group.

"We haven't done a good enough job of outreach," Castro said. "Too
many parents simply aren't aware." Many of the uninsured are the
children of legal immigrants who have language problems and are
suspicious of government, he added.

Outreach is considered to be much better in Pennsylvania, where the
state has used, among other means, TV commercials to tell residents
about CHIP.

"I saw a commercial," said Rickie Griffin, a 50-year-old West
Philadelphia widower and father of two who said he was recently laid
off from Tasty Baking Co. Though he had no job, his daughters were
receiving Social Security payments and the family was deemed to have
too much money for Medicaid.

"What was I going to do?" Griffin said. "My daughter's teeth were
messed up. When your little one is hurting, that makes you hurt more.
But I got on CHIP and they took care of it. Oh, it's fantastic."

In Pennsylvania, which has a "cover all kids" policy, every uninsured
child is technically eligible for health insurance under CHIP or
Medicaid.

The very poorest have Medicaid. For families of four making up to
$42,000 a year (which is about twice, the federal poverty definition
of $21,200), CHIP is free.

If families of four make between $42,000 and $63,000, they must pay an
average monthly insurance premium of $40 to $64 per child.

A family of four making more than $63,600 can get insurance at a cost
of $161 per child per month.

As senators battle, advocates say the increase in Pennsylvania CHIP
enrollment will only continue and the March 31 deadline is
approaching.

"A lot of kids' parents lost employment and a lot more will be turning
to CHIP," said Leonardo Cuello, executive director of the Health Law
Project. "We're worried that we'll be getting a flood of new
applicants."



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