child care - Digital Library Collections

CHILD
HEALTH
Box 2.1
A State Advocate's Checklist for l..pl....ntln. CHIP
New federal funds for children's health coverage create an extraordinary opportunity for
advocates and policy makers at the state level to give millions of uninsured children a
healthy start in life. The new CHIP program leaves most critical decisions in the hands of
states. For the initiative to achieve its promise, advocates in all 50 states must wage vigorous
campaigns supporting the best possible health coverage for as many uninsured children as
possible. Advocates should urge state and community decision makers to:
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Give the federal government a state plan well in advance of July 1, 1998. Plans must be
approved by October 1, and the approval process could take months. States that fail to
submit their proposals in time may have to turn over their 1998 federal grants to other
states. The funds are available now; states should move quickly to serve children without
delay.
Use the existing Medicaid (EPSDT) program, which was developed for children, rather than
create a largely duplicative new program that may not meet children's needs. Medicaid
provides the benefits children need. And using this existing program, rather than creating a
new program with a separate bureaucracy, means more money for children's health care
and less for administrative costs.
Cover as many uninsured children as possible. At a minimum, states should cover children
with family income up to 200 percent of the federal poverty level ($26,660 for a family of
three in 1997), because their parents are least able to afford private insurance that covers
the entire family.
Ensure that fears of employers dropping coverage are not used as an excuse to leave children
uninsured. In states that have adopted generous public programs to cover uninsured
children, officials report no resulting change in employer-sponsored family health coverage.
Companies cut dependent benefits to save labor costs, whether the state does a lot or a little
for uninsured children.
Use a family·friendly application process that cuts red tape. Let families apply either by mail,
at public and community health providers and organizations, or at the welfare office.
Develop a simple one- or two-page application form that is easy for parents and community
agencies to use and requires a minimum ofsupporting paperwork from parents.
States using separate state programs instead of Medicaid should take the following steps:
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Keep costs affordable for low-wage, working parents. According to CDF's analysis ofCensus
Bureau data, the average family income ofan uninsured child is $20,800 a year. For families
at this income level, even a small payment for health insurance comes directly out of the
family budget for other essentials, such as food and utilities. Minnesota thus limits premiums
to $4 a month for low-income children. When states have asked low-wage, working
parents to pay more, many children have remained without health care.
Provide comprehensive benefits for children. Model benefits after Medicaid. Cover preven·
tive care, including immunizations and well-ehild care through age 18. Tailor coverage to
CHI L D R EN'S D E FEN S E FUN D 27