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Child Watch® Column: "Keeping a Child Healthy Shouldn't Be This Hard"

Release Date: May 11, 2007

Marian Wright Edelman

Children get sick occasionally. Parents expect it and always hope they never get anything more than a cold, but they want to be prepared for the worst. Part of that preparation is making sure their children have health insurance. Millions of low- and moderate-income families can't afford private insurance and are eligible for Medicaid or the State Children's Health Insurance Program (SCHIP). But either they are unaware of this important fact or the application process is so complicated that it takes many months or longer for a child to be covered. Sadly, long delays in getting health coverage are all too common. That's why the Children's Defense Fund is seeking this year to blend the two programs and make enrollment automatic.

Unless a change is made, more and more families will experience the nightmare of the Uhr family. Richard Uhr, a retired AT&T employee in Houston, Texas, worked for a full year to get his grandson's SCHIP coverage renewed. Richard's son, Robert, Sr., contracted meningitis at six months old and is deaf and cannot speak. His only means of communication is through a teletype machine or computer, which makes it difficult to carry on any type of business with a government agency. He worked long enough to qualify for Social Security disability insurance and has a disability pension. The family learned that Robert, Jr., his 11-year-old son, was eligible for half of his father's Social Security benefits and Medicaid health coverage as well. Things went well until a cost of living increase put Robert, Sr.'s income above Medicaid's eligibility limits. The family was informed that young Robert's health coverage would be transferred to SCHIP. There were no problems until his coverage came up for renewal. The extensive six-month renewal form and supporting documents were too difficult for Robert, Sr., to manage so Richard Uhr stepped in to advocate for his grandson.

The renewal application was submitted. After a long wait, the Uhrs received a letter informing them that Robert, Jr., was going to be disenrolled from SCHIP. Richard Uhr was concerned because he knew he had applied for renewal. He called to learn of the status of the renewal application and faxed a copy of the original. That was returned with a request for additional information. Over the course of a year, Richard received 18 letters requesting different—and often conflicting—missing information on his grandson's application. Names and case numbers were incorrect, records were lost and the family continued to be asked to submit information that already had been provided.

Numerous calls ensued but none of Richard Uhr's attempts to communicate with SCHIP administrators yielded satisfactory results. He finally was connected with a supervisor who wasn't able to find the application in the computer system or even find Robert Uhr, Jr's account number. So Richard was instructed to go back to square one and reapply. Richard Uhr appealed to the Children's Defense Fund office in Houston for help, and Robert, Jr.'s application for health coverage was ultimately renewed.

This is just one example of why the majority of America's nine million uninsured children are eligible but not enrolled in federally supported health insurance programs. Daunting bureaucratic barriers and complicated eligibility rules are common in many states. Richard notes that in Texas, when you register your children for school, parents' incomes are provided, and on that basis, eligible students are enrolled in the school lunch program. Inclusion in health care should be that simple. The All Healthy Children Act (H.R.1688) would make child health coverage that easy.

Passage of this measure will guarantee health and mental health care for all children and pregnant women in America now. Bureaucratic barriers to coverage would be eliminated. Children currently enrolled in Medicaid, SCHIP and other means-tested federal programs like school lunch and food stamps would be enrolled automatically. The process of getting uninsured children enrolled—and keeping them covered—would be streamlined and simplified.

In the interim, Richard Uhr says, "I'm concerned about the millions of other children who may not have a relative with the persistence, stamina and communication skills that I happen to have. Some just give up, and it should not be that way." I agree with him. Children's access to health care in America should not depend on the lottery of geography. Why should a child in one state have fewer benefits than a child in another state? Why should children of different ages in the same family have different benefits? It is not the child's fault that the parents cannot afford private insurance. Every child in the United States deserves a healthy start in life and the right to reach adulthood, regardless of where they live. That won't happen unless you help now. Please go to www.childrensdefense.org/healthychild.