FAYETTEVILLE : Better care for kids sought
Posted on Thursday, December 4, 2008
FAYETTEVILLE — Arkansas’ 69, 000 uninsured children face several major hurdles in gaining access to health care, particularly through the state’s Medicaid program for youngsters, health advocates say.
For one thing, two-thirds of that group are eligible for ARKids First, but for whatever reason haven’t signed up. For the rest, they face hurdles to getting the coverage or finding doctors who accept it.
A three-pronged approach is needed, said Elisabeth Wright Burak, health policy director for Arkansas Advocates for Children and Families, during a forum Wednesday in Fayetteville.
So the group’s Arkansas Finish Line Coalition initiative first will seek broader access to ARKids First, the children’s Medicaid program in Arkansas.
“Medical bills are a leading cause of bankruptcy for families,” Burak said during the health forum, which drew roughly 85 people to the Reynolds Boys and Girls Club in Fayetteville.
Families shouldn’t have to choose between buying groceries and other basic necessities and paying for uninsured medical costs, she added.
The group is calling for an expansion of ARKids First cov- erage among those currently eligible, loosening the eligibility requirements themselves as other states have done, and allowing middle-income families who aren’t eligible to buy into the coverage.
Of that 69, 000 uninsured, an estimated 46, 000, or roughly two-thirds, are eligible for ARKids First coverage but for some reason don’t have it, Burak said.
This might be addressed in part by simplifying the steps families must take to renew ARKids First coverage they already have, she said. Overall the first step involves getting more families to sign up, then stay signed up.
Another panelist, Dr. Eduardo R. Ochoa Jr., a general pediatrician at Arkansas Children’s Hospital, said he sees a need to get parents who lack documentation to prove they’re legal U. S. residents to sign up their children, who were born in this country and thus are legal U. S. citizens.
“We do need to do a better job of covering kids who are eligible,” said Ochoa, who is also assistant dean of minority affairs for the College of Public Health at the University of Arkansas for Medical Sciences and president of the state chapter of the American Academy of Pediatricians.
Second, Arkansas Advocates wants to raise the state’s eligibility from 200 percent of the federal poverty level, or $ 42, 500 annual income for a family of four, to 300 percent of the level, or $ 63, 600 for four.
At least 20 other states have expanded eligibility by raising the family income limit, Burak said, adding this includes some adjacent states such as Missouri, Tennessee and Louisiana.
The third goal of the group is providing another way into the program for families whose incomes are too high to meet its eligibility criteria.
“There are still families who, for whatever reason, can’t get insurance even at higher income levels,” she said. “We think they should be able to buy into the program.”
This might even benefit the insurance program itself.
“Certainly that would help with the risk pool, as they say in ‘Insurance Land, ’” Burak said, referring to insurers’ tendency to favor larger coverage groups and to studies that have linked higher income levels to better health.
But even if the group accomplishes all three goals, there will still be ARKids First recipients who lack primary care physicians, at least until the state’s medical school, UAMS, can make headway on its current plan to educate and graduate more medical doctors, the panelists said.
The doctor shortage means not all card-carrying ARKids First recipients can find a primary physician who is still accepting Medicaid patients. Burak said her group is seeing this problem in central and northeast Arkansas, but that it’s more severe in Washington and Benton counties.
It was estimated in 2005 those two Northwest Arkansas counties had between 6, 000 and 7, 000 ARKids First children who lacked a primary doctor, said another panelist, Kathy Grisham of Community Clinic at St. Francis House in Springdale.
Before Community Clinic became a federally qualified health center in 2005, it wasn’t seeing any ARKids First children for general medical care, Grisham said, adding that it only treated children under the ARKids coverage’s dental provisions. That changed with its new status, which in part allowed it to seek federal grants.
“We began accepting them, and there were more than we could take,” she said. Eventually, the clinic began to work all the children in, though children seeking preventive care usually must wait longer than acute cases, particularly during cold and flu season.
These days, 43 percent of Community Clinic’s medical clientele are ARKids patients, she said, as is 40 percent of its Rogers branch.
Wednesday’s Arkansas Advocates forum was hosted by the Northwest Arkansas Hometown Health Improvement Project, a coalition of health agencies and medical providers.
The Fayetteville forum was one of seven the group is holding across the state, the others being in West Memphis, Jonesboro, Little Rock, Mena, Russellville and El Dorado.
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