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Although Cover the Uninsured Week 2007 drew to a close on April 29, advocates of universal coverage work to share their message year-round in an effort to keep this growing problem high on the national agenda.

With the State Children's Health Insurance Program (SCHIP) legislation up for reauthorization this year, the Robert Wood Johnson Foundation (RWJF), founder of the annual Cover the Uninsured Week, chose to focus its 2007 efforts on the 9 million children – on average one of every eight kids – without health benefits in this country.

Of that number, "75 percent of children who are uninsured have parents who work," said Elaine Arkin, director of Cover the Uninsured Week and a special communications officer for RWJF.

Earlier this spring, her organization released a report looking at employer-offered insurance trends over the past decade.

"For families making $80,000 for a family of four, about 80 percent are offered health insurance by their employers," said Arkin, adding that the coverage rate has held pretty steady since 1997.

However, she continued, when parents make a more modest salary … less than $40,000 for a family of four … then the most recent numbers show only 47 percent are offered health insurance by their employers, and that is a 9 percent drop since 1997.

"We call this a double squeeze … these are the families who are really just getting by, and they're not offered insurance and can't afford to buy it," she noted.

Of the 9 million uninsured children, Arkin said many of them probably do qualify for SCHIP but aren't enrolled for a variety of reasons.

"One of the biggest reasons is that parents just don't realize their kids are eligible because they work," she said. Arkin added that when state budgets get tight, the first thing that goes is outreach and awareness programming to parents. The second thing that happens is that SCHIP enrollment is closed … even if only temporarily.

"States open and close the opportunity to be enrolled in SCHIP as their budget allows," she pointed out. Arkin continued that a parent who has unsuccessfully tried to enroll a child in the program might mistakenly think their child will never be eligible.

To help counter these issues, the American Hospital Association, Catholic Health Association and Federation of American Hospitals—all national partners of Cover the Uninsured Week – are urging their respective memberships to be diligent in trying to enroll children in available SCHIP, Medicaid or other safety net programs.

Although every hospital and private practice routinely asks for an insurance card, too often the process stops when a parent says they're child isn't covered. RWJF and the hospital associations would like to see more people take the next step. By sharing the free government line, 877-KIDSNOW, healthcare workers can easily and effectively chip away at the number of children without medical benefits. When parents dial the number, they are automatically routed to an operator in their state who has information on local programming and eligibility requirements. Additionally, Arkin said her organization has free materials that front office staff can hand to parents as a reminder.

"That's an example of how to make it a sustained effort," Arkin noted. "If they are seeing an uninsured patient, chances are it's an acute need. It's a real moment when a parent might pick up a phone," she said of making the most of an opportunity to direct parents to resources that would help not only the family but also benefit providers who bear the brunt of charity care.

Additionally, Arkin encouraged physicians, who are often viewed as opinion leaders within the community, to speak out about this issue. Statewide statistics along with national facts and figures, tips on writing editorials, and information on policy positions are available online at www.covertheuninsured.org.

Third, Arkin encouraged healthcare professionals to contact their medical societies and find out what is being done at the organizational level.
Finally, she reiterated, the SCHIP reauthorization vote is crucial this year. RWJF is working closely with the American Academy of Pediatrics plus Families USA, the American Medical Association and the three major hospital associations to make sure the program is continued and adequately funded.

By contacting Congressional representatives and urging them to vote to reauthorize SCHIP legislation, medical professionals have the opportunity to help make sure this country's kids are covered.

"The Robert Wood Johnson Foundation believes everyone should have access to health coverage, and this is an important first step to get as many of the 9 million uninsured children covered as we can," Arkin concluded.


May 2007

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