Monday, July 08, 2002

ECKBERG: More kids get health insurance


Daily Grind

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        One trend of health care availability in the late 1990s is pretty clear — significantly more children had insurance coverage in 1999 than four years before and that is due in large measure to the expansion of Children's Health Insurance Programs (CHIP) nationally.

        Both the percentage and number of children uninsured for the entire year declined between 1996 and 1999 from 10.3 percent, or 7 million, to 7.8 percent, or 5.4 million.

        As more children became insured, however, the recent study from the Agency for Health Research and Quality found that coverage for people earning $10 to $15 an hour fell at a startling rate.

        The lead federal agency for research on health-care quality, costs, outcomes and patient safety found the risk of being uninsured for workers in those categories increased from 10.6 percent to 12.9 percent.

        The research shows that companies have not been able to solve the perplexing puzzle of how to insure everybody who works. In other words, what's bad is bound to get worse.

        “We still have a major problem with lower paid workers and their access for health care for themselves and families,” says Sharron DiMario, executive director Employer Health Care Alliance, a non-profit association representing employer health-care purchasers.

       

Small firms suffer

               The alliance, which represents large and small firms though 50 percent of the members employ between 100 and 500 people, expects to see the number of uninsured adults continue to climb.

        As more and more companies grapple with 17 percent to 20 percent annual increases, the inevitable result is dropped coverage. “Smaller employers won't be able to bear the annual increases,” Ms. DiMario said.

        The drop in uninsured children is due to the expansion of approaches commonly known as Children's Health Insurance Programs.

        The 1998 federal budget included $24 billion for CHIP. It was the largest single expansion of health coverage for children in more than 30 years.

        The Kaiser Family Foundation found in 2000 that Ohio had 66,649 children enrolled in CHIP; about 52,653 were enrolled in Kentucky; and Indiana had 45,572 enrolled.

        At their inception, the programs generally offered Medicaid coverage to children 14 through 18 years of age who were in families at or below 100 percent of the federal poverty level.

        Later phases covered children in families whose incomes were above 150 percent of the federal poverty level and up to and including 200 percent of the level.

        That is $36,200 in annual income for family of four. The enrollment is expected to plateau, according to EP&P Consulting, a Washington, D.C., firm that offered up its evaluation of the Indiana system in April 2002.

       

Effort pays off

               T.J. Redington, professor of medicine at the University of Cincinnati and medical director of Ohio Medicaid, said CHIP programs can tend to crowd out private medical insurance because employers let the federal program pay for medical needs of workers' children.

        All studies and reports have one thing in common, Ms. DiMario said.

        “States have really spent a lot of time and money in promoting these programs, and the success you see is reflected in those numbers,” she said.

        Contact John Eckberg at 768-8386 or jeckberg@enquirer.com.

       



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