By Sandy Alexander
WASHINGTON – A Maryland program to bring health insurance to poor children has exceeded supporters’ hopes, giving the state a head start on President Clinton’s call to reach even further into communities that lack health coverage.
Since July 1998, extensive community outreach has helped the state enroll over 64,000 children from low-income families in the Maryland Children’s Health Insurance Program (M-CHIP), surpassing its goal of 60,000 over three years.
“We’re showing that when we do a good, intensive outreach program it works,” said Jan Schmidt, government relations director for the Baltimore-based Advocates for Children and Youth.
The Maryland program provides health insurance coverage for children whose families earn up to twice the poverty level. Before it started, eligibility for state-funded health care was cut off at 185 percent of the poverty level for the youngest children and it could be cut off at 40 percent of the poverty level for older teens.
Clinton last week proposed $5.5 billion of new federal support for similar state programs aimed at increasing the number of children enrolled in state insurance programs. It was part of a broader $110 billion plan he will present to Congress to increase access to insurance for low-income families and other individuals who have difficulty getting coverage.
Debbie Chang, Maryland’s deputy secretary for health care financing, said the state has already done a lot of things that are in the president’s plan.
In Maryland, for example, many county health departments already collaborate with schools to make eligible families aware of M-CHIP and provide them with forms. The president has proposed spending $345 million over 10 years to allow school lunch programs to share information with Medicaid programs.
Where Maryland counties now make M-CHIP forms available in libraries, doctors’ offices, schools, community centers and other locations, Clinton has proposed spending $1.2 billion dollars over 10 years to authorize more sites to enroll children in such programs.
Clinton also wants to spend $4 billion to require states to simplify enrollment. When Maryland began its program, it created a streamlined, three- page, mail-in application.
“We’ve made it as easy as we can,” said Ned Wollman, assistant director of the state Medical Care Policy Administration’s Office of Eligibility. “We decided to do that right up front in July 1998.”
Maryland health officials have advertised M-CHIP statewide through billboards, posters in trains and buses, and radio spots. Local health departments have used health fairs, mailings and door-to-door campaigns in addition to traditional advertising and media coverage. Program information has even appeared in children’s report cards and on Halloween bags, movie screens and McDonald’s tray liners.
Local health departments also work with social service agencies, doctors, day care centers, schools, employers and community groups to reach potential enrollees, with much success, they said.
Anne Arundel County has enrolled well over 90 percent of the children that health officials estimated were eligible when the program began, said Mary Ann Woodzelle, division director for community outreach.
“We just can’t keep up with the volume of them,” she said. Her office is hiring more staff to handle paperwork from new applicants and from individuals applying for a continuation after a year on the program.
Charles County saw a 588 percent increase in enrollment over a previous children’s insurance program, said Marcia Miller, a county health department outreach worker. She said families in the program typically express a great sense of relief because “having uninsured children is pretty frightening.”
Schmidt said Advocates for Children and Youth will continue to help the state improve the program.
“We’re going in the right direction,” Schmidt said, but “we still have a lot of uninsured children.”
Her group wants to see more school involvement and ways to reach adolescents who may be eligible for the program. Advocates also want to make sure that services are comprehensive and that state tracking ensures that children are getting what they need.
“We’ve done a lot of thinking to improve the process and reach out to people, ” said Chang. “Maryland’s story is a success story in terms of enrolling people.”