BY B.G. GREGG
The Cincinnati Enquirer
Tessa Cash, 10, right, has evere asthma. Behind her (L-R): siblings Holly, Andrew, mother Vicki, Jonathan, and Katie.
(Glenn Hartong photo)
|
ZOOM |
|
When 10-year-old Tessa Cash began coughing and wheezing Thursday, her parents did something they once feared to do when she had an asthma attack.
They went to the hospital.
The Price Hill family signed up for the Children's Health Insurance Plan (CHIP) in March, and Tessa's parents now have the peace of mind that insurance brings.
"When you have insurance, you can get up and go," said Vicki Cash, Tessa's mother. "When we didn't have the insurance, we'd put it off and say, "Maybe she'll get better,' or we'd try to do some sort of home treatment.' "
Until four months ago the Cash family was one of the estimated 23,000 Hamilton County families without insurance for their children. Community leaders have tried to help those families, and on Tuesday they will kick off a million-dollar campaign to recruit and sign up people for the no-cost insurance program.
Officials say the reasons are practical as well as humane: Paying for checkups, shots, eye exams and other preventive care now is cheaper than paying for emergency or long-term care later, they say.
"You don't even have to have a social conscience to know this is the best bang for your buck," said Randy Garland, president and CEO of the Cincinnati Health Network, an affiliation of local independent health centers.
|
HOW TO APPLY
|
|
Here's how to apply for the Children's Health Insurance Program:
 Those 18 and under, and pregnant women, whose families earn less than 150 percent of the poverty level are eligible. That means families of four can earn up to $2,056 in gross monthly income. Families of six can earn up to $2,756 a month.
Call the CHIP application center at 531-9999 beginning July 28.
A CHIP specialist will determine whether you are eligible and help you apply by either phone or mail.
Those who apply will receive coverage in four to six weeks. |
President Clinton recently made $500 million available to local communities to publicize the insurance program, which is available to any family whose income is less than 150 percent of the federally defined poverty level. Hamilton County plans to use its $1 million portion of the federal money on television, radio, billboard and even bus advertising to let people know that the program is available.
A 1997 study by Families USA, a non-profit organization that lobbies for affordable health care, found that there were 773,000 uninsured Ohio children for at least one month in 1995 or 1996. The same study found 310,000 children in Kentucky and 503,000 in Indiana. Across the country, the organization found that 23.1 million children, one-third of all children, were uninsured for some time during those two years.
Many of the children are members of two-parent, working families. According to Barbara Berger -- executive director of the Ohio Caring Foundation, which for nine years has collected private donations to pay the medical costs of uninsured children -- her families are:
Mostly two-parent (56 percent)
Mostly white (85 percent)
Mostly employed (percent not available).
"This is a segment of the population Medicaid has not historically served," she said. "It is a higher-income, more self-sufficient population."
Her typical family profile fits the Cashes. Vicki and William Cash have known each other since Mrs. Cash was 11 and Mr. Cash was 16. They started dating five years later and were married 13 years ago.
The couple has seven children. Mr. Cash previously worked for a hardware company, and had insurance until he was laid off in 1992. Mrs. Cash was a Head Start teacher until she became pregnant with Andrew, 1.
Since 1992, Mr. Cash has worked a series of odd jobs without benefits, or with unaffordable benefits. He now works for a moving company. "When you don't have insurance, you get up every morning and you pray to yourself that no one falls, no one breaks a bone and no one gets sick," said Mrs. Cash.
Her prayers were not always answered. Tessa has had asthma problems since birth and spent a great deal of time in intensive care. Jonathan, 6, was hospitalized for 19 days with spinal meningitis shortly after birth.
Mrs. Cash estimates the family has $25,000 in unpaid medical bills, and that is after much of the costs were written off by hospitals. She said medical treatment was on an emergency basis only when she didn't have insurance, but, since hearing about the CHIP program at a school meeting, she now feels good about taking the kids in for checkups and other treatment.
"I would recommend that people take advantage of this," she said. "It really takes a load off."
But many officials are worried that many who are eligible won't take advantage of the free insurance.
Many of the working poor are proud and don't want to accept handouts, said Jean Masterson, an associate director of the Jordan Center, a Price Hill facility that helps uninsured adults with medical care.
Also, she said, "they don't trust institutions," "don't, or can't leave their neighborhood for care," and "don't feel comfortable filling out forms."
Mrs. Cash agreed, saying she knows several families that wouldn't sign up for CHIP.
"They'd say, "People are going to think I'm a nobody, that I don't work,' " she said.
Ms. Berger said a survey of 110 families in her program showed that half wouldn't sign up for CHIP. She cited many of the same reasons listed by Ms. Masterson.
"If we're creating a system that isn't really attractive to families, are we really being wise on how we spend our tax money?" asked Ms. Berger.
Both women say the state will have to do a good job of selling the program and tailor its sales approach to appeal to different communities. Hamilton County has hired an advertising firm to do just that, said Mindy Good, director of communications for the Department of Human Services.
The county has invited 2,300 people from local doctors' offices, clinics, hospitals, churches, social service agencies, schools and other institutions to a Tuesday kickoff for the CHIP program. Ms. Good said the invitees will learn what CHIP is all about and how they can get families signed up.
Doctors should be happy to cooperate. Mr. Garland estimates clinics in his network lost $600,000 last year from treating the uninsured.
"At the end of 1997, 51 percent of our users were uninsured," he said. "That was up from 43.3 percent at the end of 1996. If we could get back to a 40 percent level, we could work back to a break even point (on losses) and stay in business."
The problem stretches well beyond Hamilton County.
Stephen Wilhide, president and chief executive officer of the Southern Ohio Health Services Network, a chain of clinics in Clermont, Adams, Brown, Fayette and Highland counties, said his company lost a record $1 million last year, mostly from treating the uninsured.
He estimates a 35 percent increase in uninsured patients over the past three years.
Without this program, the number of uninsured children would most likely grow. Welfare reform has pushed many off of the welfare rolls -- causing them to lose their Medicaid cards -- and into low-paying jobs without benefits or with unaffordable benefits.
While making changes in the welfare system, both reform opponents and proponents conceded that more money would have to be spent on support services, such as child care or medical insurance.
The two major-party candidates for Ohio governor, Republican Bob Taft and Democrat Lee Fisher, both have made insuring children of the working poor a campaign issue, endorsing a state task force recommendation that the eligibility limits for CHIP be expanded to 200 percent of the poverty level, allowing the state to insure 40,000 more children.
But, if families don't sign up, what good will it do expanding the program? Ms. Masterson holds out hope that many families will see the light, just like the Cash family.
"The state is trying to make this as user-friendly as possible, and I really laud that," she said. "In the end, parents will do for their kids what they won't do for themselves. Hopefully, this is something they will see as important."
