By Robin Christian, Children First for Oregon
In this time of economic uncertainty and political
division, last week brought us some welcome good news in Oregon.
According to the Oregon Health Authority, the number of
uninsured children has dropped dramatically in less than two years – from 11.3%
to 5.6% – thanks to the affordable, quality health insurance provided by the
Oregon Healthy Kids initiative. This puts Oregon on the leading edge of efforts
to connect kids with coverage and shows how a little forward thinking can
create better outcomes for children.
Oregon Healthy Kids is free or low-cost health care
coverage for Oregon children and teens. Currently, all uninsured
Oregon children living in families who make less than $44,000 a year for a
family of four (200% FPL) may be eligible to receive no-cost health coverage
through Healthy Kids. Children in families of four making as much as $66,000 a
year (300% FPL) may be eligible for low-cost coverage through the program, and
children in families of four making above that amount are able to buy into this
high-quality, comprehensive program.
But as you can imagine, just making coverage available
was not enough to ensure that 94,000 previously uninsured children would have
access to a doctor’s care. Instead, the Healthy Kids initiative has been
successful because it combines extensive outreach efforts with the hard work
needed to reduce unnecessary barriers to enrollment.
The Office of Healthy Kids, in partnership with Children
First for Oregon, ran a well-coordinated campaign, using focus groups,
marketing firms, and “boots on the ground” efforts. Groups of families with
children currently enrolled or potentially eligible helped revise the Healthy
Kids application, ensuring the language would be easily understandable to the
intended audience. Culturally specific materials and marketing were developed
by small marketing firms that were familiar with Oregon’s various ethnic
groups. State staff coordinated
outreach efforts regionally and throughout Oregon schools to utilize and
support the application assistors and outreach grantees that live throughout
the state.
The Office of Healthy Kids also revised the application,
removing unnecessary “required” information and utilizing existing information
sources for eligibility determination.
The application was revised to reduce income documentation requirements
to one pay-stub and one parent’s signature instead of two. Oregon now uses
existing data for citizenship and income verification, such as income
information provided through the Supplemental Nutritional Assistance Program
(SNAP) and Free & Reduced School Meal programs, as well as Social Security
Administration data on citizenship. Using data from these systems reduces the
number of pended applications and the amount of additional information that
applicants must provide. The SNAP income data also helps identify children who
are likely eligible for Healthy Kids but are not yet enrolled. Their families
are mailed short application forms with pre-populated income information,
notifying them that their children can be “express-laned” into Healthy Kids.
And yet, as the federal budget negotiations drag on, the
budget axe is threatening to cut into Oregon’s success. Some proposals in
Congress would roll back funding for Medicaid by as much as 33 percent, which
could undermine health care coverage for up to 56% percent of Oregon’s
currently enrolled children. This is exactly the wrong time for Congress to cut
off funding for children’s health care. The federal government must address the
deficit, but taking health care away from the 94,000 families and children
enrolled in Oregon Healthy Kids in the last two years would be the wrong
approach.
(Robin is also the former Chair of the Kids Count National
Steering Committee for the Annie E. Casey foundation.)