Nearly two-thirds of Americans under age 65 have been covered
by private employer-sponsored insurance, through their jobs or through the jobs
of a spouse or parent. Yet private health insurance is covering fewer people.
A September report from the U.S. Census Bureau found that, due to a decline
in employment-based insurance, the number of uninsured Americans had risen by
about 1.4 million in 2001, bringing the total to 41 million. Of course, rising
unemployment rates mean more people without health insurance. But double-digit
increases in health-care costs have also played a role by prompting some employers
to drop health-care benefits or raise the amount contributed by workers.
What is the effect on kids? A Centers for Disease Control and
Prevention (CDC) survey found that the proportion of children covered by private
health insurance dropped between 2001 and the first quarter of 2002, from 67.1
to 63.8 percent.
When the economy slumps, public insurance such as Medicaid
often picks up some of the slack. In 1997, the U.S. Congress designed the State
Children's Health Insurance Program (SCHIP) to cover children in working families
whose income was too high to qualify for Medicaid. The CDC found that between
2001 and 2002, the proportion of children covered through Medicaid and SCHIP
rose from 23.4 percent to 27.7 percent. Had that growth not occurred, about
two million more children would be uninsured.
Still, many children remain needlessly uninsured. The Urban
Institute estimates that there are 8 million uninsured kids in the United States.
Five million of those are eligible for SCHIP or Medicaid but are not insured.
Here is where programs like Health Care For All come into play ("Chipping Away,"
Nov. 26).
Since 1999, "walkers and talkers" from Health Care For All
have been going door to door in New Orleans' housing projects and surrounding
working-poor residential areas. Their focus: enrolling residents in Medicaid
and LaCHIP, Louisiana's version of SCHIP. Many of the residents are not aware
that their children are eligible; some find the form too complicated or require
assistance due to low literacy. During the first six months of this year alone,
the program completed 509 applications for children.
The work of Health Care For All has been nationally recognized.
The state of Louisiana has also been recognized for its outreach efforts with
LaCHIP since it launched the program in 1998. Louisiana has most recently been
commended for its work toward improving the program's renewal rates.
It's no wonder, then, that kids in New Orleans for the past
year been enrolling in LaCHIP and Medicaid at a rate of nearly 45 kids a day.
Just one year ago, there were 66,280 New Orleans children enrolled in the two
programs; today there are 82,547.
The state estimates that between 100,000 and 150,000 Louisiana
children still remain uninsured. More than 80 percent of uninsured children
live in families where at least one person works. Continued "aggressive outreach"
such as that done by Health Care For All is crucial, especially in this economic
climate.
Louisiana, like many other states, is also considering insurance
for parents. "We're paying for their care anyway," notes Louisiana Department
of Health and Hospitals secretary David Hood, explaining how the charity-hospital
and private-hospital systems already pick up the tab for ill parents.
The Kaiser Commission on Medicaid and the Uninsured estimates
that there are 10.6 million uninsured parents in the United States and that
7.4 million of those could be insured if coverage were expanded to include parents
at the same income levels as children. Other states have already begun insuring
parents, partly to benefit children. Clearly, healthy parents are better able
to care for their children. Research also shows that a child with an insured
parent is more likely to be enrolled in Medicaid/SCHIP and is more apt to receive
regular health care.
True health care for all remains a distant goal, but Louisiana
is on the right track. Further outreach is needed so our families get the coverage
they need. In many cases, it's just a visit and a form away.
