July 12, 2002

There Are Options For Providing Health Care To Our Children, Family Economist Says

There is good news for many children without health care, according to a North Dakota State University family economics expert.

Health insurance is an area where most of the news seems to be bad news. Even if your family is adequately covered, confusing billing, the filling out of forms, and explanations of benefits are stressful matters. "Even harder on parents is the inability to afford health coverage at all," says NDSU Family Economics Specialist Debra Pankow. "There are alternatives for families who cannot afford a health care plan or health care for their children. In North Dakota, qualified family’s children can be covered by Medicaid, the State Children’s Health Insurance Program, or Blue Cross/Blue Shield of North Dakota’s (BCBSND) Caring Program for Children.."

NDSU Extension is involved in promoting the State’s Children’s Health Insurance Program (SCHIP), also known as Healthy Steps, to rural families. North Dakota’s Healthy Steps is a product of the Title XXI initiative passed by Bill Clinton as part of his Balanced Budget Act of 1997, and is targeted at providing health benefits for children of families that cannot provide private medical insurance but whose income is too large to qualify for Medicaid. Families whose income is too large to qualify for Healthy Steps and don’t qualify for Medicaid may be eligible for the BC/BS Caring program.

According to Pankow, current Medicaid benefits in North Dakota cover the health needs of children ages 7 through 17 whose families have incomes of 100 percent of poverty or less. The federal poverty level (FPL) is indicated as being a family of four with an income of $18,100 or less. Children up to age 6 are covered if the family’s income is at or below 133 percent of this level or $24,073.

Each state’s plan is based on its own availability of funds with matching federal funds. The goal is to provide insurance for families that, prior to SCHIP, were unable to afford insurance. Pankow says, "Healthy Steps is premium-free, with low co-payments (the amount that the parent has to pay per service), and it is available to families with incomes of up to 140 percent of the federal poverty level. North Dakota’s plan also provides preventive vision and dental benefits."

Currently in North Dakota, more than 20,000 children are receiving Medicaid benefits, and nearly 2,500 children are enrolled in Healthy Steps. This is a considerable increase from the number of children that were enrolled when the program started in 1998. "The problem is that there are still over 10,000 uninsured children in North Dakota," says Pankow. That is where BCBSND’s Caring Program for Children comes in. Funded by corporations, community and church organizations, and private donations, the Caring program currently provides coverage for almost 600 children, and is always sponsoring fund drives to be able to expand. BCBSND contributes all administrative costs so that 100 percent of all donations go to the children.

Other than increased health for North Dakota’s children, perhaps the major benefit of these programs is an increase in the satisfaction of the parents. "One of the major hurdles faced by Healthy Steps right now is informing the public about the program and the requirements for qualification," comments Pankow, adding "Families that qualify are unaware that while they may not qualify for Medicaid benefits, they do qualify for Healthy Steps." Focus group research with parents of uninsured children show that five of 10 parents with children that qualify for SCHIP or Medicaid do not believe that these programs apply to them.

The good news is that simply getting the message out there may be enough. Seven of 10 parents of unenrolled children said that they would enroll them if they knew they qualified.

Information about North Dakota’s Healthy Steps program, application procedures, and benefits can be found on the Web at http://www.state.nd.us/childrenshealth/ or call toll-free 1-800-755-2604. Information about BCBSND’s Caring Program for Children is available by calling 1-800-342-4718.

For further information contact your local NDSU Extension Service office.

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Source: Debra Pankow, (701)231-8593, dpankow@ndsuext.nodak.edu
Editor: Tom Jirik, (701)231-9629, tjirik@ndsuext.nodak.edu
Writer: Scott Lowell, (701)231-7882, slowell@ndsuext.nodak.edu