FP Report -- February 1999 Help CHIP help children get health care
A federal program enacted in 1997 provides $24 billion for states to provide health insurance to low-income children. Enrollment efforts for the Children's Health Insurance Program are now under way, but many parents -- and even many doctors -- are unaware of how to tap this resource.
Jeff McKinley, D.O., a second-year resident at the Family Medicine Residency Program of Topeka in Topeka, Kan., examines a 10-month-old patient. Faculty physicians at the residency are enrolled as providers in the state Children's Health Insurance Program, which is called HealthWave. They share information about the program with uninsured patients, who make up about 8 percent of the practice.
(Photo by Sharon Dickinson Dent/AAFP)Audrey Boyd, M.D., of Columbia, S.C., a member of AAFP's Commission on Legislation and Governmental Affairs, urges physicians to enroll as providers in their state's CHIP and educate families about getting health insurance for their children.
Boyd says new federal programs often raise a red flag for physicians, which may impede efforts to get children insured. For instance, doctors may balk at the potential administrative burdens. Although such concerns aren't unwarranted, many states are making changes to alleviate the paperwork hassles, she says.
"Because the United States is trying to push insurance coverage for children, a lot of changes are being made in the system to make it easier for us to manage these children," says Boyd, volunteer medical director for Hope for Kids, an organization that works to get children insured and immunized. "Here in South Carolina, we no longer have to file on separate forms for Medicaid children, for instance."
Another barrier to getting physician providers enrolled is the belief that patients receiving federal assistance will be noncompliant.
"I think these patients really want to do the right thing and work within the system," Boyd says. "If it's a respectful system and they feel they have a family doctor who cares about them, then patients will respond differently. Create continuity and develop relationships with your patients to alleviate the stigma attached to the federal programs."
Karen Bruce, M.D., director of the Family Medicine Residency Program of Topeka in Topeka, Kan., says all of the residency's faculty doctors have enrolled as providers in the state's CHIP, which is called HealthWave. She says the FPs also treat patients at a local indigent clinic, but now HealthWave will enable many of those families to get health insurance for their children and better continuity of care at a private practice.
"I think it's excellent," Bruce says. "We provide a pretty significant amount of care to Medicaid kids, and the benefits you see longitudinally of caring for these kids beats the heck out of catching them in the emergency room."
So far, families are signing up for CHIP in much smaller numbers than anticipated. Boyd attributes the slow enrollment to a lack of information. She encourages physicians to offer CHIP flyers and applications at their practices and to teach office staff to discuss CHIP with potentially eligible families.
"Because physicians are looked upon as an authority in health care, if we tell patients about this program, they'll listen," she says. "We have to play a major role in educating the public and getting the information out."
Where can you find details on your state's program? See the box below.
What's CHIP?
The Children's Health Insurance Program gives grants to states to provide health insurance for children below age 19 living in families with incomes at or below 200 percent of the federal poverty level. Some states are using the money to expand Medicaid, while others are launching new programs to privately insure eligible youngsters.
According to the Children's Defense Fund, benefits vary by state, but children enrolled in the program generally are eligible for regular check ups, immunizations, eyeglasses, doctor visits, prescription drug coverage and hospital care.
Where can you get more details? Try these resources:
- The Children's Defense Fund web site features extensive information about CHIP, including flyers for each state program with phone numbers of state offices. Go to http://www.childrensdefense.org/signup/index.html and download a flyer for distribution to patients.
- Use AAFP Express to receive by fax a federal flyer that includes some information about CHIP, as well as phone numbers for regional offices. See the box on page 2 for details on ordering the flyer.
FP Report is published by the AAFP News Department. Copyright © 1999 by American Academy of Family Physicians.
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