Insurance program aids poor children

About 1,300 uninsured children in the county are eligible for coverage by the Ohio plan.
By WILLIAM K. ALCORN
VINDICATOR STAFF WRITER
YOUNGSTOWN -- Mahoning County has the second-lowest percentage of uninsured children among Ohio's eight most populous counties, despite having the highest rate of children in families with incomes 200 percent below federal poverty guidelines.
About 4.4 percent of Mahoning County's children under 18, an estimated 2,607, were uninsured in 2004, according to the Health Policy Institute of Ohio.
HPIO is an independent, nonpartisan organization that analyzes health issues.
Using data from the 2004 Ohio Family Survey, HPIO also said 53.9 percent of Mahoning County's children lived in families with incomes 200 percent below federal poverty guidelines.
The guidelines, usually issued in February or March, serve as one indicator for determining eligibility for federal and state programs.
"This encouraging decline in the number of uninsured children can be attributed to the enrollment of more families in Ohio's Children's Health Insurance Program known as Healthy Start/CHIP," said Matthew A. Stefanak, commissioner of the Mahoning County District Board of Health.
He credited an aggressive outreach effort, coordinated by Mary Lou Carbon under a contract with the Ohio Department of Jobs and Family Services, for significantly reducing the number of uninsured children over the last several years.
In 2000, the Mahoning County District Board of Health and Ohio Children's Defense Fund estimated that Mahoning County had 5,500 uninsured children, said Stefanak, co-author of the report on the 2004 survey.
Work to be done
However, despite the enrollment increases, Stefanak said work remains to be done.
HPIO estimates that 1,297 of the 2,607 uninsured children, almost half, would be eligible for Healthy Start/CHIP if they were enrolled.
"Most of the 1,297 eligible children live in families where one or both parents work, but don't have employer coverage and/or they can't afford to purchase coverage for their children," Stefanak said.
Carbon said there are several obstacles to getting people enrolled in Healthy Start/CHIP.
Atop the list is the mistaken belief by many that Healthy Start/CHIP is a "welfare" program; and the lack of understanding of eligibility requirements and the coverage available.
First, Carbon said, Healthy Start/CHIP is not a welfare program. It is primarily for the working poor, and eligibility is based on gross income. Assets such as a house and car are not factored in. Also, she said, families may apply for CHIP and receive their children's health insurance care approval through the mail without a face-to-face interview with a Job and Family Services intake worker.
Healthy Start provides prenatal care and CHIP provides comprehensive coverage for outpatient, emergency department, and inpatient medical services as well as vision, prescription and dental care, all with no co-payment or deductible, Carbon said.
Guidelines
She said children who qualify for free and reduced lunch programs at their schools and the Women Infants and Children program are eligible for CHIP. Children living in families whose annual income is 200 percent of the federal poverty level are eligible, Stefanak said.
Under the guidelines, a family of four can earn up to $40,000 a year, and the children would be covered by Healthy Start/CHIP. A family of eight can earn up to $67,200 and still be eligible, Carbon said.
Healthy Start/CHIP also can cover the adults in families that are income eligible. For instance, if a parent wishes to be placed on the plan, a family of four can qualify with an $18,000 annual income. Healthy Start/CHIP also can be used to supplement other insurance plans, Carbon said.
Stefanak said the lack of health insurance has a particularly insidious affect on the health of children. Many studies have shown that families with uninsured children frequently delay or forgo preventive health care and seek acute care in hospital emergency departments. The families also are likely to delay child immunizations, Stefanak said.
Adolescents, in particular, can benefit from the guidance of a trusted health advisor to help them through a period when their bodies are changing and they may be tempted to take risks, such as having unprotected sex or using drugs, alcohol or tobacco, Stefanak said.
He said physicians and social service providers are in an excellent position to link families with CHIP. Also, he urged uninsured families, or those whose insurance plans do not cover all services, to call the CHIP consumer hot line at (800) 324-8680 to see if they qualify.