Routine medical visits, immunizations, acute care for illness and injury, and ongoing care for chronic conditions, are necessary to ensure that children have a healthy start in life. Unfortunately, without adequate insurance, many families cannot afford to provide their children with the care that they need. As a result, government programs such as the Children’s Health Insurance Program (CHIP) have been created to give all children access to quality health care.
Using information from the Community Health Data Base’s 2004 Southeastern Household Health Survey, the following article examines the number of uninsured children in Southeastern Pennsylvania (SEPA) and the associated costs of being uninsured. The article also offers information on some of the resources available for families who cannot afford health insurance for their children.
Uninsured Children in Southeastern Pennsylvania:
Trends in Insurance:
Nationally, the percent of uninsured children has decreased in the past few years, from 13.9% in 1997 to 9.4% in 20031. In Southeastern Pennsylvania, the percent of uninsured children has also decreased, although not as dramatically. In 1996, the percent of uninsured children was 5.1%. This figure decreased to 2.7% by the year 2000. Currently, the percent of uninsured children is 4.7%, representing 44,180 children in the region. (See Figure 1)
The Costs of Being Uninsured:
Routine medical visits, preventative care, and acute care for injuries and illnesses are critical to providing children with a healthy start in life. However, uninsured children often do not have access to quality medical care due to the cost. They are also less likely than children with insurance to have a regular source of care, and instead are more likely to visit free clinics rather than a doctor’s office. As a result, they are less likely to receive continuity of care.
· One out of four uninsured children in SEPA do not have a regular source of care (24.8%), compared to only 4.4% of insured children. (See Figure 2)
· Uninsured children are three times more likely than insured children to have not been to a doctor in the past year (23.0% vs. 7.7%). (See Figure 2)
· In SEPA, 23% of uninsured children did not receive dental care due to the cost, as compared to 5.1% of insured children. (See Figure 2)
· In SEPA, 15.3% of uninsured children did not receive eyeglasses due to the cost, as compared to 2.3% of insured children in the region. (See Figure 2)
Insuring the Uninsured:
Nationally, nine out of ten uninsured children are from families with working parents, who unfortunately do not have insurance through their employers and cannot afford to insurance for their families2. Fortunately, for many of these uninsured children, health insurance is available through a program called CHIP.
Children’s Health Insurance Program (CHIP)
Recognizing a need for quality health care for all children, CHIP was created in 1997 to provide health insurance for children of working families who otherwise cannot afford health care, but do not qualify for other government insurance programs such as Medicaid. CHIP is administered on a state-by-state basis and subsidized by forty billion dollars in federal matching funds that were allocated over a ten-year period to provide coverage for uninsured children. CHIP covers regular examinations, immunizations, emergency room visits, prescriptions and dental coverage for children.
To qualify for CHIP, children must be from working families living below 200% of the federal poverty level3. For example, a family of four (including parents) could be eligible enroll their children in CHIP if their income is below $45,000 per year4. A family of three could be eligible to enroll their children in CHIP if their income is below $37,000. (For a list of exact income eligibility requirements, please refer to www.state.pa.us, PA keyword: CHIP)
Prior to the creation of CHIP in 1997, 13.9% of children in the United States were uninsured5. By 2003, this percentage decreased to 9.4% of children6. According to the Pennsylvania Insurance Department, there are now more than 133,700 children enrolled in CHIP in the state of Pennsylvania, and 43,250 children enrolled in CHIP in the Southeastern Pennsylvania region7.
Despite availability of health insurance through CHIP and other programs such as Medicaid, there are still 44,180 children in the region who do not have any private or public health insurance. Many of these children are eligible for CHIP or Medicaid, yet their families do not know about the programs or do not realize their children are eligible.
· Among the uninsured children in the region, approximately three out of five are living below 200% of the federal poverty level and could be eligible to receive insurance through CHIP (61.4%).
· This project to 27,120 children in the region who could be CHIP eligible yet remain uninsured.
· Approximately thirty percent of parents with uninsured children report that they have never heard of CHIP (29.8%).
Informing families about CHIP and enrolling eligible children in the program can greatly reduce the number of uninsured children and improve the quality of their health care.
Applying for CHIP is easy. Parents can call 1-800-986-KIDS (5437) to find out if their children are eligible and enroll them in the program. For more information about CHIP, please visit www.state.pa.us, keyword: CHIP, or call the number above.
For information regarding PHMC’s Community Health Data Base 2004 Household Health Survey, or to learn more about uninsured children in Southeastern Pennsylvania, contact Diana Levengood, at (215) 731-2039 or dianal@phmc.org.
Notes:
1. National Health Interview Survey. Findings reported in the Department of Health and Human Services, Office of Inspector General, SCHIP: State’s Progress in Reducing the Number of Uninsured Children. http://oig.hhs.gov/oei/reports/oei-05-03-00280.pdf
2. Children’s Defense Fund. http://www.childrensdefense.org/childhealth/chip/key_facts.asp
3. Department of Health and Human Services, Office of Inspector General, SCHIP: State’s Progress in Reducing the Number of Uninsured Children. http://oig.hhs.gov/oei/reports/oei-05-03-00280.pdf
4. For a list of eligibility requirements, please see the following brochure: http://www.ins.state.pa.us/ins/lib/ins/chip_ab/final_cover_brochure.pdf
5. Department of Health and Human Services, Office of Inspector General, SCHIP: State’s Progress in Reducing the Number of Uninsured Children. http://oig.hhs.gov/oei/reports/oei-05-03-00280.pdf
6. Department of Health and Human Services, Office of Inspector General, SCHIP: State’s Progress in Reducing the Number of Uninsured Children. http://oig.hhs.gov/oei/reports/oei-05-03-00280.pdf
7. PA Department of Insurance. http://www.ins.state.pa.us/ins/cwp/view.asp?a=1279&q=527110
