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November 2, 2009

STANCZYKIEWICZ: Health insurance and Indiana children

With the emotional debate on national health care reform beyond a fever pitch, you might be surprised by the data on health insurance and Indiana children. Even more surprising is the fact that part of the solution might be in your own backyard.

According to two federal surveys, the percentage of Indiana kids without health insurance is better than the national average. The U.S. Census Bureau reports that eight percent of Hoosier children are uninsured. The national average is 12 percent.

The Census only counts kids who are without health insurance for the entire year. Another federal measurement, the National Survey for Children’s Health, counts children who are uninsured for even one month in a year. That survey finds 14.7 percent of Indiana children lacking consistent health insurance. The national average is 15.1 percent.

Indiana also is ahead of the national average for access to private health insurance. The Census finds 73 percent of Hoosier children covered by private health benefits, compared with 65 percent nationally.

That still leaves nearly 123,000 Hoosier children without health insurance. Importantly, the majority of these kids — 59 percent — are eligible for existing public health plans but are not signed up. With access to health care so vital, how can eligible children not be enrolled?

“For some people there is a stigma, but I’m finding that a lot of people just don’t understand that their children are eligible,” said Judy Jacobs, the outreach manager for the Windrose Health Network. Through its Family Health Centers, Windrose serves low-income residents in Bartholomew, Brown, Johnson, Marion, Morgan and Shelby counties.

Jacobs said some families are overwhelmed and intimidated by the public health insurance application. Others do not have transportation to state-sponsored application sites. And still others move so often that they can not be reached by state government with program updates or eligibility information.

That is why Jacobs does not sit in her office. Instead, she goes out into the community to find children and families who are eligible for public health insurance.

“I will meet them at their local library or at their local Wal-Mart or at a drug store. Whatever works best for them,” Jacobs said. “I also work hand-in-hand with school corporations. When kids are getting enrolled in school and applying for the free and reduced lunch programs, I’m available right there for the parents to fill out the health insurance application.”

Public health insurance is available to eligible Indiana children through a program called Hoosier Healthwise. Children in families with incomes at or under 150 percent of the federal poverty level ($33,084 for a family of four) receive free health care. Families between 150 percent and 250 percent of poverty (up to $55,128 for a family of four) pay monthly premiums ranging from $22 to $70.

The number of eligible children is likely to grow. Census data released late last month show Indiana’s poverty rate increasing to 13.1 percent, up from 12.3 percent the previous year.

All of us can be involved through service clubs, religious congregations and community organizations to help eligible but uninsured children and their families enroll in existing public health programs. (The State of Indiana publishes the list of application sites at: http://www.in.gov/fssa.)

However, even if all eligible children were enrolled in Hoosier Healthwise, more than 50,000 Indiana kids would still be uninsured, not qualifying for public health insurance and not able to purchase private health coverage.

Finding a solution for them, and all children, is well worth the effort. Children with health insurance are more likely to have a regular doctor who can provide personalized care based on a consistent knowledge of the child’s medical history. As a result, researchers have found insured children are likely to have better health, lower rates of hospitalization and lower rates of childhood mortality than their uninsured peers.

Importantly, children with health insurance tend to perform better academically and socially since being sick and missing school are barriers to academic achievement.

The scope of any public policy proposal is determined by the size of the problem being addressed. While the federal data can inform our legislators, the efforts of Judy Jacobs can inform the rest of us on how to be part of the solution.

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