The Final Call

Bridging the gap in health care coverage for children

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Graphic: MGN Online

Advocates in California say help is there, but too few people know about it.

Part of the help they are referring to is Healthy Families, California's State Health Insurance Program, which provides low cost medical, dental, and vision health coverage to children whose families earn too much money to qualify for free health insurance.

According to Kidsdata.org, which promotes the health and well being of children in California by tracking different health indicators, Black children are about 13,000 of the 900,000 enrollees in the Healthy Families program, compared to Latinos at 51 percent with Whites and Asians at just under 10 percent.

“Once you face barriers dealing with low income and already marginalized populations who are taking care of families and dealing with the hurdles of trying to put food on the table, health care just gets pushed aside,” said Annie Park, a policy director at Community Health Councils, Inc., a non-profit health advocacy group.

The biggest hurdle for the program was to avoid cuts and denying health insurance access due to California's $19 billion budget deficit, but with President Barack Obama's extension of the State Health Insurance Program, Healthy Families will run through 2013 and beyond, according to advocates.

The hurdles to health insurance for many families include long waiting lists and complex application requirements, which vary from county to county. “Imagine somebody that has to take off of work to fill out an application, they only have a limited amount of time.They may have to be on the bus system, and in Los Angeles and many major cities, the bus system is horrible, so it's not a simple process to get through,” said Sonia Vasquez, a policy director for the Community Health Councils.

Although Healthy Families and Medi-Cal, the state's free insurance program, have tried to provide applications in different languages, potential enrollees are dealing with workers who do not speak their language creating anxiety that prolongs the process.

“But that should not be a barrier to getting children insured,” said Kelly Hardy, health policy director for Children Now, a national child advocacy organization.“Health insurance is important because uninsured children admitted to the emergency room are 60 percent more likely to die than insured children ... insured children are more attentive in school and preventive care is cost effective.”

To overcome the language barrier and bridge the divide between needy families and public health insurance, Healthy Families utilizes Certified Applicant Assistants to help enroll families in the program.

In part, to qualify, children must be 18 and under; without employer-sponsored health insurance in the last three months of their application; and cannot be eligible for or enrolled in Medi-Cal.

Applications are available at www.healthyfamilies.ca.gov and families can find out in 10 days or less whether their children are eligible.

The program's Health-e-App Public Access allows families to enroll online (www.healthyfamilies.ca.gov). For information on public health insurance across the U.S., families can visit https://www.cms.gov/home/chip.asp.

Once enrolled in the Healthy Families programs, a monthly premium between $4 and $24 for each child is paid, but no more than $72 for each family. The co-payment is $5 to $15 for visits and some services.

To qualify, a family's income can be up to 250 percent of federal poverty guidelines. The guideline for a family of four is $22,050 and for a family of six, $29,530, according to the Department of Health and Human Services 2009 Poverty Guidelines.

Nearly one million children in California are uninsured, but 600,000 are eligible for Healthy Families or Medi-Cal, according to the California Endowment, a private health foundation. It works to get children insured by connecting families and health insurance programs through day care centers.

Fabiola Magdaleno doesn't mind speaking out to help raise awareness about help that exists.She and her children were covered through a health plan at her husband's job, but her daughter contracted a disease and had a seizure two months before he was laid off from work and lost his insurance.

Insurers called the child's disease a pre-existing condition.The family could not afford extended coverage offered by their former plan and MediCal denied their request for emergency coverage, she said. Advocates helped enroll her children in Healthy Families.

“At the end of the day, when you can't provide your kids with health care and their other needs, you feel you've failed as a parent,” Ms. Magdaleno said.“We are your regular American family who worked hard, paid our bills, and tried to provide for our family, but when you run into trouble and don't qualify for anything, what do you do?I feel that we've done everything right ... We're not insured right now, but at least our kids are.”

The program also helped Marie Antoinette, a Black, married mother of three. Mrs. Antoinette's children were covered through her husband's job plan, until the job was lost. “Without Healthy Families insurance, none of my three children would have been able to see a doctor on a regular basis nor have vision coverage. We were told in order to keep insurance on just my husband and myself, the monthly premium would have been $800 with minimal coverage,” Mrs. Antoinette said.