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Health insurance for kids
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April 20, 2000: 12:11 p.m. ET
Medicaid, SCHIP programs help those who have fallen through the cracks
By Staff Writer Shelly K. Schwartz
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NEW YORK (CNNfn) - If you're like most American families, the practice of dragging your kids to the doctor's office each year for routine check-ups is a given.
After all, it's the most effective way to catch and treat small problems before they become larger ones. And it's the easiest way to ensure your children get their immunizations to stay healthy in the first place.
But to millions of hard-working parents, preventive care is a luxury they can't afford.
Such is the case for low-income families earning too much to qualify for Medicaid, but not enough to purchase health insurance coverage on their own -- a dilemma prevalent in the service industry, in which employee benefits are rare.
Thanks to new and expanded government programs, however, the children of service industry workers don't have to suffer.
"I think there's an issue here with the separation of Medicaid from the welfare program," said Richard McGreal, a spokesman for the Massachusetts Health Medicaid program. "People say, 'Well I'm not going to qualify. I make too much money.' But we try to tell people that even though they aren't eligible for welfare benefits anymore, their kids (and in some cases they themselves) still have access to the Medicaid program."
A two-pronged approach
Today, the two primary sources of free and low-cost health insurance for kids are Medicaid and the State Children's Health Insurance Program (SCHIP).
Medicaid, which was broken off from the new cash welfare program in 1996, is a jointly funded, federal-state health insurance program for low-income and needy people. It covers some 36 million individuals including 18 million children, the elderly, blind, and/or disabled, and people who are eligible to receive federally assisted income maintenance payments.
 States set their own eligibility requirements for Medicaid, and the majority cover children whose family incomes range from 100 percent to 150 percent of the federal poverty level. For a family of four, that level is $17,050 this year.
A few states have opened the Medicaid door to children in families earning up to three times the poverty level.
And still others have implemented a new type of program to pick up where Medicaid leaves off. That's where the State Children's Health Program (SCHIP) comes in.
Passed as part of the Balanced Budget Act of 1997, the program provides $24 billion over five years, plus additional funding for Medicaid expansions and annual grants to states. The program covers uninsured children who are 18 and younger, either through an expansion of the existing Medicaid plan, the creation of a separate program or a hybrid of the two.
"The idea was to expand coverage to the children of working families," said Chris Peacock, a spokesman for the Health Care Financing Administration (HCFA), an agency under the Department of Health and Human Services. "The next area of expansion you may see is coverage for the whole family."
(Click here to find out what child health care benefits your state offers.)
To find out more about the SCHIP or expanded Medicaid coverage for children in your state, you can check out the Insure Kids Now Web site. The page includes information on the importance of health insurance for kids and a detailed description of the program benefits available in all 50 states, plus five U.S. territories and the District of Columbia.
You can also call the toll-free hotline: 877-KIDS-NOW. The number automatically routes callers to the program enrollment office in their state.
Streamlining the process
Under the SCHIP program, states may either cover children with family incomes above the Medicaid eligibility threshold but less than twice the poverty level, or up to 50 percentage points over the state's current Medicaid income limit for children.
SCHIP remains the single largest expansion of health insurance coverage for children in more  than 30 years. And according to data, the program is growing.
Since the program was created two years ago, some 37 amendments to state SCHIP plans have been approved by the Health and Human Services Department.
Georgia, Indiana, Oklahoma and Massachusetts are among the states that have eased eligibility requirements for children, and undertaken massive outreach programs to ensure all kids who are eligible are signed up. Some states are simplifying the enrollment process and others are helping to foot the medical bills for working adults as well.
It's a comprehensive initiative that appears to be paying off.
A study released earlier this month by the Kaiser Commission on Medicaid and the Uninsured notes a 28 percent spike in program enrollment between December 1998 and June 1999. The growth, it states, is being driven largely by Medicaid expansions undertaken through SCHIP.
"One of the biggest problems with federal and state health programs has been outreach," Peacock said. "There's a lot available to working families."
And a lot more may be available in the coming years.
President Clinton's 2001 budget proposal includes provisions to insure additional children, including giving states the option of extending SCHIP to children up to age 20, expanding the program to parents of eligible children and allowing the school lunch program to share information with Medicaid and SCHIP. The proposal also would expand the number of sites authorized to enroll children in Medicaid and SCHIP, and require states to make enrollment in both programs equally simple.
The ranks
According to HCFA, there are 11 million uninsured children in this country today.
As of last fall, some 2 million children were signed up for state child insurance programs nationwide. Another 4 million who are eligible for state health assistance, however, are not enrolled.
"It is inconceivable that a country with as much economic prosperity as we now enjoy, and the best health care system in the world, would leave 10 million - now nearly 11 million - children without health insurance," President Clinton said at a Children's Health Outreach event last year. "We know many of them are eligible for Medicaid, but their parents don't know it. We know there are a lot of hard working families now whose incomes are too high to qualify for Medicaid, but they apply, or qualify, for the Children's Health Insurance Programs now that the states are operating around the country. But they don't know it."
As the lines that separate Medicaid and SCHIP slowly blur, program administrators hope the national health care program that emerges will give working families the resources they need to get to keep their kids healthy. 
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