Nonprofit seeks more in ARKids
Posted on Sunday, May 25, 2008
Arkansas Advocates for Children and Families plans to increase enrollment in the state health insurance program for children by 22, 000 over the next three years.
Eleven percent of Arkansas children, or about 70, 000, are uninsured, according to the Little Rock-based nonprofit. Of those, an estimated 44, 000 are eligible but not enrolled in ARKids First.
Arkansas ranks 32 nd in the nation — tying with South Carolina — in the percentage of uninsured children, according to the Kaiser Family Foundation. Michigan is first with just 5 percent of children uninsured. Texas is last with 21 percent of children uninsured.
“We could make a big dent in the state’s uninsured rates if we could just get all the kids eligible for ARKids First enrolled,” said Rich Huddleston, director of Arkansas Advocates for Children and Families.
The group also hopes to work with state and federal officials to raise eligibility requirements to cover more children.
Arkansas is one of eight states participating in the Finish Line project, paid for with grants from the David and Lucile Packard Foundation, created in 1964 by the co-founder of the Hewlett-Packard Co.
Arkansas will get $ 675, 000 from the foundation over three years and a projected $ 264, 000 in federal matching grant money, Huddleston said. Other states participating are California, Colorado, Iowa, Ohio, Rhode Island, Texas and Washington.
Arkansas Advocates for Children and Families is partnering with groups around the state to increase enrollment, including Healthy Connections Inc. in Mena; Delta Area Health Education Center in Helena-West Helena; Child Development Inc. in Russellville; Mid-South Health Systems Inc. in Jonesboro; and South Arkansas Regional Health Center in El Dorado.
Finish Line has similar goals as a project that launched the health insurance program for children of low-income families 11 years ago. The Covering Kids in Arkansas campaign was paid for with the help of a grant from The Robert Wood Johnson Foundation, and ran from January 1999 to 2003. The number of kids enrolled in ARKids First grew 70 percent during that time.
“In 1997, we were one of the worst states in the country for uninsured rates,” Huddleston said. “We made huge strides, but we should never think that our work is over.” Elizabeth Wright Burak, Arkansas Advocates’ health policy director, said Finish Line will try to reach children they haven’t successfully reached in the past.
“This is going to be more difficult because these are kids that have been eligible but for whatever reason haven’t enrolled,” Burak said.
A statewide survey found ensuring that children have access to high quality, affordable health insurance coverage is the top concern of Arkansans in regard to children’s health care, according to the 2007 Natural Wonders report by Arkansas Children’s Hospital.
INCREASING ENROLLMENT ARKids First rolled out in 1997, expanding enrollment for children beyond traditional Medicaid with the help of federal waiver funding from the State Children’s Health Insurance Program. The first year, more than 26, 000 kids enrolled in ARKids First B, the waiver portion of the program that covers children in families with income up to 200 percent of the federal poverty level, or $ 42, 400 a year for a family of four. About 350, 000 children are enrolled in ARKids program, including about 245, 000 traditional Medicaid recipients and 105, 000 waiver recipients, said Julie Munsell, spokesman for the Arkansas Department of Human Services.
Rachel Simpson of Benton enrolled all three of her children, ages 5-17, in ARKids after a physician told her about the program six years ago.
It has helped the family cover vaccinations and medical expenses, including asthma medication for her 5-year-old son, Logan, and four years of tests and exams for her 7-yearold daughter, Katlyn, who had kidney problems.
Simpson said she and her husband can’t afford health insurance offered at his job as a commercial electrician. The family policy costs about $ 5, 200 a year, has a $ 1, 000 deductible and co-pays of $ 25 per doctor visit.
“It’s just too much,” said Simpson, who works part-time as a clerk in a doctor’s office. “That gets expensive when you’re trying to pay your bills and take care of your kids too.” Each year, Simpson gets an ARKids re-enrollment form. She has to answer questions verifying her children still qualify for the program and send it back to the Arkansas Department of Human Services. If she doesn’t return it, her children lose coverage.
“It would probably be something that would slip a lot of people’s mind,” Simpson said. “It’s human error.” Getting families to fill out the re-enrollment forms is a challenge, Munsell said. Parents may forget, move, or decide they don’t need the coverage. Often parents don’t realize their children have lost coverage until they get to the doctor’s office. “Many families are busy and they don’t think about healthcare coverage until their child is sick,” she said. Over the next few months, Finish Line partners will begin holding sessions to educate parents around the state, and work with community leaders, schools, public forums, churches and other entities to get the word out, Burak said.
COVERING MORE KIDS Bob Young, executive director of Healthy Connections Inc., a community health center in Mena, said one of the center’s main focuses will be working with school nurses. In July and August, nurses will be trained to help parents fill out applications for ARKids First, and set up a system to remind parents about re-enrollment.
Healthy Connections, which also participated in the Covering Kids campaign, will spread the word through various public and private groups, including churches, clinics, and doctors’ and dentists’ offices.
“Our issue is we have so many kids and families and enrolled, the ones that aren’t enrolled now are apparently difficult to reach or difficult to convince,” Young said.
Part of the campaign will be correcting misconceptions about the program, such as the belief that children have to have immunizations to participate, he said.
“It’s the future of our children that’s going to be at stake if we don’t do something about improving their health situation,” Young said. “We’re already seeing an obesity epidemic and early signs of a type 2 diabetes epidemic in this generation. This is a way to address this issue before it becomes a more serious problem.” Arkansas Advocates for Children and Families will also work with legislators and the state Department of Human Services, with the hope of extending ARKids eligibility from 200 percent to 300 percent of the federal poverty level, or $ 63, 600 for a family of four. The expansion would affect about 20, 000 Arkansans.
Huddleston said he would also like the state to offer families above 300 percent of poverty an option to pay for ARKids coverage.
As private health-insurance premiums rise, more middle income families are losing health-care coverage, he said. Many families have incomes too high to qualify for ARKids First but too low to afford private insurance.
“People on both sides of the aisle [Democrats and Republicans ] agree that we should cover kids, but the question is how are we going to do it,” Huddleston said.
Munsell said any effort to expand income limits will have to go through the Department of Human Services and be approved by the U. S. Center for Medicare and Medicaid Services.
Whether the effort is successful depends a lot on what happens at the federal level with the State Children’s Health Insurance Program. Congress tried last year to increase spending for the program by $ 35 billion over five years, to bring total spending to $ 60 billion, but the effort was twice vetoed by President Bush.
Bush said the expansion would encourage too many families to drop private coverage for government coverage, according to news reports.
Munsell said the Arkansas Department of Human Services has had “preliminary conversations” with federal officials about expanding ARKids First coverage, but “at this point it doesn’t look that favorable.” “It’s a lot more difficult to get the federal government to move on waivers when funding is in question,” Munsell said. “We obviously want to insure as many kids as possible, but that effort cannot come at the expense of existing programs.
“ It might be awhile before we can move forward on any change.”
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