Madam Speaker, I rise today in strong support of H.R. 2, the Children's Health Insurance Program (CHIP) Reauthorization Act. Our nation must show true compassion for the most vulnerable among us, and CHIP helps millions of low-income…
Madam Speaker, I rise today in strong support of H.R. 2, the Children's Health Insurance Program (CHIP) Reauthorization Act. Our nation must show true compassion for the most vulnerable among us, and CHIP helps millions of low-income children receive healthcare.
The last time we had a floor debate on H.R. 2, there were references made by those in opposition to the bill to a program in my state called Keiki Care. It was suggested by those individuals that the Keiki Care program was cancelled due to perceived crowd-out, where parents drop their children's private insurance in order to enroll into a free government program.
That claim was entirely false, and I join Congressman Abercrombie in correcting the misstatements made by the opposition. The Keiki Care program did not have an issue with crowd-out. It was intentionally designed so that those who wish to enroll in the program must be continuously uninsured for six months. There was also no spike in program enrollment that even suggests that parents were indeed dropping their private insurance to join. I would like to insert into the Record a fact sheet on Keiki Care published by the group Hawaii Covering Kids.
In Hawaiian, ``keiki'' means ``child'' or taken literally ``little one.'' H.R. 2 is a bill that provides for the health and well-being of the keiki most in need of our help. I urge my colleagues to join me in voting in support of H.R. 2 today.
Keiki Care
Goal
All children and youths living in Hawai`i are enrolled in
health insurance.
Children's Health
Compelling national health care statistics drive Hawai`i
Covering Kids' goal:
Children who are uninsured are twice as likely not to
receive any medical care;
Only 45% of uninsured children had one or more well-child
visits in the past year compared with more than 70% of
insured children;
More than one in three uninsured children do not have a
personal physician; and
Uninsured children are less likely to receive proper
medical care for common childhood illnesses such as sore
throats, earaches, and asthma.
Background Information
Approximately five percent of Hawai`i's children and youths
are uninsured statewide which means over 16,000 kids do not
have health insurance. Hawai`i Covering Kids sponsored
meetings in October 2006 and January 2007 to determine the
``gap groups'' and possible solutions. We concluded these
children and youths are most likely uninsured:
Eligible for QUEST or Medicaid Fee-for-Service in
households between 251-300% FPL but parents cannot afford
monthly premium payments;
In families with incomes above 300% FPL and parents cannot
afford private health insurance;
Have temporary visas (V, H, K, etc.);
Undocumented immigrants; and
Student dependents (F2 visa) whose parents cannot afford
university health insurance plans.
2007 Initiative
The Hawai`i State Legislature introduced HB1008, now Act
236, to help uninsured children and youths in the gap groups.
It included paying QUEST and Medicaid Fee-for-Service monthly
premiums for children between 251-300% FPL and establishing a
free Keiki Care plan for children ages 31 days to 19 years
old who are ineligible for public health insurance. The Keiki
Care plan is modeled after the low-cost HMSA Children's Plan
with limited benefits and some out-of-pocket expenses. It
requires the child live in Hawai`i and be continuously
uninsured for six months. Exceptions to the six-month
uninsured provision include: (1) children who ``income
out'' of QUEST or Medicaid Fee-for-Service, (2) children
enrolled in a managed care children's plan on the
effective date (one-time only exemption), (3) newborns
uninsured since birth, and (4) children in families
affected by Aloha Airline's bankruptcy.
Timeline
3 May 2007--HB1008 HD2 SD2 CD1 Passed by the Legislature;
30 June 2007--Signed by the Governor as Act 236;
1 March 2008--Enrollment Commenced;
1 April 2008--Keiki Care Effective Date.
Enrollment
1 April 2008--1,827;
1 November 2008--2,021.
Crowd-Out
Hawai`i has never experienced problems with parents
dropping their children's private health insurance to enroll
them in public-financed programs. Keiki Care specifically
discourages this tactic (called ``crowd-out'') through an
eligibility requirement that each child must be uninsured
continuously for six months, limited benefit package, and
some out-of-pocket expenses. The
fact enrollment in November 2008 isn't significantly greater
than when Keiki Care began illustrates crowd-out prevention
is working.
Outreach
Hawai`i Covering Kids has conducted intensive outreach
through broadcast emails to state and community partners,
mailouts to statewide outreach workers, web site information,
211 hotline referrals, and natural points of contact
including community health centers, hospitals, public health
nurses, Head Start, WIC, and schools.
Economic Impact
The modest investment in Keiki Care pays off in several
significant ways. It supports healthier children, confident
parents, and reliable payments to health care providers while
preserving precious charity care and limited uninsured funds
for those who are uninsurable. Keiki Care empowers parents by
connecting their children to a pediatrician and regular
preventive health care. Should a sudden illness or injury
occur, the children are also insured for emergency care which
averts personal and institutional financial crises. In fact,
as the number of insured kids has increased in Hawai`i,
hospital emergency department data for 2000-2006 show that
visits by uninsured children and youths have declined from
5.25% to 3.79%.