By Ben Koller, Community Catalyst
Last month, children’s health advocates and experts from around New England gathered for the New England Alliance for Children’s Health’s (NEACH) annual Children’s Health Care Summit. NEACH, an initiative of Community Catalyst, is a broad-based coalition of health advocates, providers, and legal experts dedicated to improving children’s access to high-quality, affordable health care. This year’s summit reflected some of the emerging issues of importance in children’s health, with sessions covering social determinants of health and payment innovation, among others.
While these emerging issues are exciting and important, there was also discussion at the Summit about the original core focus of the NEACH coalition’s work: the continuous battle for health care access and coverage for children. CCF’s recent annual report lists all states’ percentages of uninsured children, and showcases the relatively positive status of children’s coverage in New England. Five out of the six New England states rank in the top one-third of the country; Massachusetts led the way at #1 in the country, and Vermont and Rhode Island were both in the top 10 as well. While these results are not surprising to most, many observers may not realize how much work goes into keeping children’s uninsured rates low in New England.
Most of this work towards strengthening children’s coverage falls into two categories: outreach end enrollment work to get kids covered, and monitoring the status of existing coverage in order to protect those gains. Outreach and enrollment work is a vital and never-ending aspect of enhancing children’s health coverage. Whether through CHIP, Medicaid, or Marketplace plans, there are many children and families who are eligible for coverage, but currently not enrolled. One example of outreach and enrollment work in New England is the ‘New Hampshire Partnership to Increase Coverage in Communities of Color’ (NHPICCC). A partnership led by NH Voices for Health, NHPICCC seeks to educate communities of color on their coverage options, and assist them in enrolling in the appropriate programs. Outreach work such as this is a critical part of ensuring that the rate of uninsured children stays low.
Most New England states are fortunate enough to have environments conducive to protecting and promoting children’s access to care. However, there are still regular threats to coverage to which advocates must respond. Recently in Connecticut and Rhode Island, the threat of roll backs in coverage for parents (which would in turn affect children) forced advocates to leap into action. In 2013, the Rhode Island legislature voted to drastically decrease eligibility levels for parents in RIteCare, the state’s Medicaid program. Although advocacy efforts to avert the cut were unsuccessful, advocates were able to shift their focus to ensure that as many parents as possible (and thus children) retained insurance in some form. For full details on these efforts, see Community Catalyst’s brief: Parent Eligibility Roll-Back in Rhode Island: Causes, Effects and Lessons Learned. This past year, Connecticut passed a budget putting the state in a similar situation by severely reducing parental eligibility levels for HUSKY A, the state’s Medicaid program. Using the Rhode Island situation as a basis for comparison, Community Catalyst and the Connecticut Health Foundation co-released a brief outlining Connecticut’s situation, how it compared to Rhode Island, and what lessons could be learned from the efforts in Rhode Island that would help advocates mitigate the impact of this cut in Connecticut.
Despite these largely successful advocacy efforts to make and protect gains in children’s health coverage, the situation in Maine provides an example of work still to be done, as its 37th-place ranking in CCF’s report shows. Maine has perhaps the most difficult environment in New England for promoting access to care; it is the largest and most rural of the New England states, and the status of the state government presents tremendous barriers towards progress in this area. A long-term goal for advocates in Maine is for the state to finally embrace Medicaid expansion under the Affordable Care Act, although the current political climate makes that a tall task. In the interim, many advocates are focusing on increasing enrollment among the many families in the state who are eligible for MaineCare, but currently not enrolled.
Whether attempting to protect gains in states like Rhode Island and Connecticut, or bring the state up to par like in Maine, fighting for children’s coverage remains a constant effort across New England. Constant vigilance is required on the part of advocates in order to ensure that as many children as possible have access to the care that they need to be healthy. Working together, advocates across the region have made significant progress, but our work is never finished.
