Sunday, August 12, 2007
Aug. 12, 2007 (McClatchy-Tribune Regional News delivered by Newstex) --
The debate over reauthorizing a federal program that provides help for uninsured low-income children is heating up in Washington, with President Bush and Congress far apart on funding levels.
But even though the State Children's Health Insurance Program is set to expire Sept. 30, local families seem mostly unaware of the looming showdown -- and the effect in could have on Kentucky's children.
In this state, the program is known as the Kentucky Children's Health Insurance Program, or KCHIP.
The debate over the billions of dollars needed to fund the programs -- both in Kentucky and across the country -- is so far removed from a life of trying to survive that the issue doesn't register, some health care advocates said.
In some cases, 'these are families working several minimum-wage jobs to make ends meet,' said Melanie Raines, Newton Parrish Elementary School Family Resource Center director.
About 61 percent of the 420 or so students at the school qualify for free or reduced-price lunches, an indicator their families' incomes make them eligible for KCHIP, Raines said.
KCHIP eligibility is 200 percent of the federal poverty level, or an annual income up to $41,300 for a family of four.
KCHIP families struggle to get by despite working at least one job, don't take vacations or have new cars and could be financially ruined by any catastrophe, said Beth Murphy, Raines' counterpart at Foust Elementary School.
'They're probably living paycheck to paycheck,' Murphy said.
About 20 Foust students receive KCHIP, Murphy said. A majority are from homes so poor that they qualify for more help than what is provided by KCHIP and receive Medicaid coverage, she said.
Makeda Harris, a policy analyst with Kentucky Youth Advocates in Louisville, said she has heard more concern from health care advocates and educators than families. 'I've talked to lot of families in Kentucky. A lot of families aren't informed about their Medicaid and KCHIP coverage in general,' Harris said.
Raines said: 'I'm very concerned because I think there's a gap in services, anyway,' especially with dental coverage. 'A lot of families have medical insurance but no dental insurance.'
Families who get KCHIP tend to be concerned once they learn about the debate, and they are grateful for what they get, Harris said.
'They tell me they don't know what they would have done without KCHIP,' she said.
KCHIP 'a big help'
That includes Sylvia Mundy, a single mother of a 13-year-old daughter and 7-year-old son who lives in government housing on West Fourth Street.
Mundy makes just under $20,000 a year as a deputy clerk in the traffic and criminal court office at the Morton J. Holbrook Jr. Judicial Center.
KCHIP 'has been a big help,' said Mundy, who faced paying $300 a month to insure her children.
Her son has attention deficit hyperactivity disorder. The ADHD medication costs $245 a month, but it's just $2 a month through KCHIP, Mundy said.
'I wouldn't have been able to afford it,' she said.
His condition requires a doctor visit every three months, for which she has to take off from work, Mundy said.
He also wears glasses, which means an annual checkup. KCHIP pays for that and a pair of glasses each year, Mundy said.
She hasn't followed the Washington debate closely but hopes 'it doesn't become a big problem,' she said.
'I can't afford medical insurance coverage for them and provide a living for them,' Mundy said.
Reduced enrollment possible
As of March, 1,098 Daviess County children were receiving KCHIP coverage. There were 102 in Hancock County, 157 in McLean County, 486 in Muhlenberg County and 363 in Ohio County.
Both congressional proposals are designed to expand coverage to children who qualify for KCHIP but don't receive it.
Bush has threatened to veto both proposals, saying in part that it is a step toward national socialized medicine.
But his plan -- in Kentucky, at least -- wouldn't cover the 50,000 eligible children who aren't receiving KCHIP, Murphy and others said, and wouldn't even cover the number of children currently enrolled in the program.
'If President Bush does get his way, by 2011 ... we're having a shortfall. We couldn't continue with the kids we have on the roll now,' Murphy said of the 52,000 now getting KCHIP.
'That would eventually result in reduction in enrollment,' Harris said.
Keith Sanders doesn't expect funding to be decreased but feels there is a moral and social issue involved in providing funding for all who qualify.
'How can you justify doing for some and not others?' said Sanders, executive director of the Hager Educational Foundation, a private foundation aimed at providing opportunities for disadvantaged children.
'That seems to be a question of fairness,' he said.
Keeping the funding level essentially the same would not help more children, he said. 'If the president wants to extend the program, at some level it's hard to make an argument he's in favor of it,' Sanders said. 'I think it's just good public policy to do this.'
Terry Brownson, chief executive officer of Wendell Foster's Campus for Developmental Disabilities, is concerned about the long-term effect on the community.
Some of his facility's 1,080 clients are KCHIP children who are referred from the Commission for Children with Special Health Care Needs in Louisville.
'Our main concern is that kids with disabilities get early intervention services regardless of who the provider is,' Brownson said.
If their families are affected by KCHIP funding, that could mean no early help and a smaller chance for them to learn to live independently, he said. They would then depend on society for help, he said.
'It's a great example of the pay-me-now-or-pay-me-later syndrome,' Brownson said.
About The Program
In 1997, Congress created the State Children's Health Insurance Program and set aside funds for states to create health insurance coverage.
The target was children whose families make too much to qualify for Medicaid but not enough to afford health insurance on their own.
The program is set to expire Sept. 30. President Bush is proposing an increase of $5 billion in funding over five years.
A proposed U.S. Senate plan would add $35 billion over five years, for a total of $60 billion. It would be funded by increasing the federal excise tax on cigarettes.
A U.S. House proposal would add $50 billion over five years, for a total of $75 billion.
Some funding would come from a cigarette tax, as well as reducing federal payments to insurance companies that cover senior citizens through Medicare.
Parents of uninsured children can call toll-free at (877) KIDS-NOW to find out if their children qualify for free or low-cost health coverage.
Kentucky Children's Health Insurance Program applications are available at local health departments, state Department for Community Based Services offices or schools' family resource and youth services centers.
For more information or to locate one of those offices, call the KCHIP office's toll-free number at (877) 524-4718.
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