Jacksonville Health Insurance

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8 million youths have no health insurance


By J. Taylor Rushing, Capital Bureau Chief
Unable to obtain health care for her 12-year-old son, Matthew, and unable to move out of Florida, Ann Nicholson was forced to choose between keeping her son with her or sending him to another state for medical coverage.
AT A GLANCE
-- 47 million total in United States without health care (15.7 percent of total U.S. population), up from 39 million in 2000
-- Includes 8.3 million children (under age 18), or 11.2 percent of total child population
-- U.S. has lowest life expectancy and highest infant mortality rates of G7 countries (U.S., Germany, France, Canada, Japan, United Kingdom, Italy)
-- U.S. has lowest percentage of medically insured citizens of G7 countries
-- U.S. spends $8.40 in federal money per senior citizen for every federal dollar spent on children

Figures are from 2005, most recent available
Source: U.S. Census Bureau (www.census.gov), Population Reference Bureau (www.prb.org)
ON THE WEB
Online resources for more information or help:
EVERY CHILD MATTERS, a national child-advocacy group that publishes polls and reports on children’s issues, is at www.everychildmatters.org.
NATIONAL ACADEMY FOR STATE HEALTH POLICY, an advocacy and resource association of state health policymakers, is at www.nashp.org.
FLORIDA IMPACT, a 28-year-old state group working to reduce hunger and poverty in Florida, has health care information and links available at http://flimpact.org/resources/healthcare.html.
FLORIDA KIDCARE, the state’s child health insurance program for youths under 19 years of age, is at www.floridakidcare.org.
JAXCARE, a public-private agency that works to provide health care to uninsured families in Duval County, is at www.jaxcare.org.


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Nicholson, 38, of Jacksonville sent her only son to Gainesville, Ga., this summer to live with two cousins who share guardianship and got him enrolled in PeachCare, Georgia's child health insurance program. Stricken with a form of hemophilia and attention-deficit hyperactivity disorder, Matthew needs medicine that costs up to $848 for a small vial of liquid.
She sent her son away because she is unable to afford the shared costs, and unable to leave Florida because of a custody dispute with her daughter's father. Nicholson drove to Tallahassee in March to testify before a House health committee and plead her case directly to state legislators one of whom, Rep. Terry Fields of Jacksonville, was left in tears.
Yet nothing has worked. Florida's KidCare system denied coverage for Matthew, and when Nicholson sued the state Agency for Health Care Administration and won the agency provided coverage for only the first half of this year. So she sent Matthew to Georgia, and hopes to join him soon. Her 7-year-old daughter, Leeila, is healthier, but Nicholson worries for her future, too.
"It's frustrating when a mother has to fight for her son's medicine," she said. "But the price of one treatment was the price of my mortgage. I just pray every day that Leeila doesn't get sick."
Numbers are growing
More than 8 million American children go without health care, according to the U.S. Census Bureau. Twenty-seven million won't have it at some point in any two-year period. Nearly 1 million go without immunizations for childhood diseases. In the Sunshine State alone, 1 in 5 Florida children lives without health care.
The nationwide numbers vary widely with ethnicity and race: 7.2 percent of non-Hispanic white children live without health care, for example, compared with 12.5 percent of African-American children and 21.2 percent of Hispanic children.
The Deep South fares the worst: According to a Georgetown University study from 2006, 43 percent of uninsured U.S. children live in the South. Florida in particular has the nation's third-worst average percentage of uninsured children, at 19.6 percent.
The ranks of uninsured children aren't new, but they are growing. Enrollment in Florida's KidCare program peaked at 1.55 million in May 2004 before dwindling to 1.38 million currently. Legislators shrunk the program in 2004 and 2005, but reversed some of those changes after the rapid enrollment drop.
Debra Miller, healthy policy director for the Council of State Governments in Lexington, Ky., sees the trend from statehouse to statehouse.
"It's too easy to say it's a red and blue problem," Miller said. "But it is a political-will problem, and a budget-priority problem."
Not the public will
Michael Petit blames politics for the problem.
The former commissioner of Maine's Human Services Department has founded Every Child Matters, a Web site and organization that advocates more government resources for child services.
Petit's Web site, www.everychildmatters.org, publishes reports based largely on government statistics about child poverty, abuse, crime and lack of health care.
Petit said polls show conservative legislatures, even in Southern states, don't necessarily reflect the will of their populations when shrinking their child insurance programs.
For example, a June poll that Petit's firm commissioned through Mason-Dixon Inc. surveyed 800 voters in South Carolina and found 67 percent of Republican voters said they would be more likely to support a presidential candidate who advocated universal health care for children.
Although there certainly are other factors most notably the massive financial influence of the private health care industry Petit said the real motivation from state to state is political pressure.
"This entire country has embraced Medicare, and all we're talking about is making Medicare available to everyone," he said. "And Medicare is a government-run program."
But limited-government advocates say states that spend more on health care are leaving long-term damage. Michael Cannon, director of health policy studies for the Cato Institute, a libertarian think-tank based in Washington, said such states also create scenarios in which families are "trapped" into the programs because they provide disincentives for people to raise their income levels and thereby give up some government aid.
"Expanding the programs just broadens or deepens the trap," Cannon said. "Medicaid and SCHIP are ripe with these perverse incentives. Everyone is spending other people's money, and no one spends someone else's money very carefully."
Bypassing legislators
At least one state official isn't waiting for the Legislature anymore. Florida Chief Financial Officer Alex Sink launched a task force this summer to explore administrative changes to the state's KidCare program, which legislators had reduced by nearly 200,000 children through a bill signed by former Gov. Jeb Bush. Sink, a Democrat, said she created the panel to make changes that don't require legislative approval.
The Legislature already has funded enough money to add 33,000 children, but Sink said the program needs more advertising and outreach efforts to get the word out. The 10 changes recommended by her task force include extending payment deadlines, easing the application process and requirements and improving communication between agencies with similar missions.
"We just couldn't get any definite answer from our legislative leaders, and that was a signal to me," Sink said. "None of these things are mind-boggling things, but put together they can increase the program's retention."
Nicholson, for one, said she hopes the Legislature will listen this time.
"I remember asking the legislators back in March, 'Do I have to send my son away?'" she said. "And that exactly what I had to do."