States move to guarantee kids health insurance

By Michelle Diament
Gannett News Service

WASHINGTON — When Bianca Sanchez moved from the reception desk to handling insurance claims at a Chicago health-care center three years ago, it seemed like a good thing all around.


But her salary increase — from $15,000 to $35,000 annually — also had a downside: It disqualified Sanchez's 8-year-old daughter, Soledad, from receiving state-sponsored health coverage.


Sanchez could add Soledad to her employer's health plan, but that would cost $400 a month in premiums plus $480 for her daughter's asthma prescriptions, which the plan doesn't cover. Sanchez couldn't afford that option, so Soledad has been uninsured for three years. Every time she gets the sniffles, Sanchez worries. She's still paying off an emergency room visit from an asthma attack in September.


But starting in July, Sanchez won't have to worry about the cost of a doctor if Soledad gets a cold or skins her knee.


Illinois is poised to become the first state to guarantee access to affordable health care coverage for all children. Sanchez already has enrolled Soledad in the program, which will cost $40 a month.


"It's really going to change things a lot," Sanchez said, fighting back tears. Currently, she has trouble paying her bills due to the cost of her daughter's medication. "If I don't have to worry about her going out and playing, I'll finally be able to sleep easily."


Kids in other states soon may have access to similar coverage. From Tennessee to Hawaii, state leaders are touting plans that would make routine visits to the dentist or pediatrician a reality for all children, regardless of their family income.


Driving the trend is a push by state governments to do something about the 46 million people across the country who lack health insurance. While most states don't have the money to insure everyone at once, covering children is a logical first step.


"There's a political consensus that children deserve to have health care," said Genevieve Kenney, a health economist at the Urban Institute. Kids also are cheaper to cover than adults and society has an interest in caring for them.


Illinois is the only state to enact legislation so far to cover all children. And New Mexico is not far behind; that state will cover all kids under age 6 starting in July. Meanwhile, officials in at least eight other states are talking about programs to guarantee affordable coverage to kids.


Critics say such plans are unrealistic. For one, states must maintain balanced budgets and can't always live up to hefty commitments in lean times.


"I would be concerned that (with) the kind of track record Medicaid has had in growth ... how long will this be a viable option for Illinois?" said Laura Trueman, executive director of the Coalition for Affordable Health Coverage in Washington.


The Illinois program, called All Kids, will offer medical, dental, vision and prescription coverage to anyone 18 or younger. Parents will pay a premium based on a sliding scale pegged to their income.


States have traditionally offered medical coverage to low-income residents through Medicaid. And since 1997, the State Children's Health Insurance Program has covered people who don't qualify for Medicaid but can't afford private insurance. Many families, however, earn too much to qualify for that program but too little to afford private coverage.


The new state initiatives would make everyone eligible for coverage, regardless of income level.


That's essential, said Illinois' Gov. Rod Blagojevich, noting that uninsured kids aren't the children of the wealthy or even the poor but "are the children of working families."


Research shows such children are less likely than their insured peers to see a doctor when they're sick and are more likely to be hospitalized for avoidable conditions. Parents of uninsured children also are more likely to keep their kids from playing sports to avoid injuries that might generate unaffordable medical bills.


Ruth Snyder, a widow in Rockford, Ill., said she declined to call an ambulance recently when her autistic son, Cody, fell off a horse.


"If I knew we could get it covered, I would have taken him to the doctor right away," said Snyder, who lives on about $40,000 a year in disability payments and Social Security. "It's hard when you know they need treatment sometimes and you can't take them because you can't afford it."