As we approach the 1-year anniversary of the Children’s Health Insurance Program Reauthorization Act (CHIPRA), CCF thought we would pay a visit to a state that has successfully translated the promise of that new law into a reality for many Oregonians. Oregon has overcome many obstacles, including gaining legislative approval for increased revenue through an expanded tax on hospitals and insurance carriers, in order to make stable, secure and affordable health coverage options available to low- and moderate-income Oregon children.

To learn more about what’s going on in Oregon, CCF’s Liz Arjun spoke to Cathy Kaufman, manager of Oregon’s new Office of Healthy Kids.

CCF

Can you tell us what’s going on in Oregon for children’s coverage?

Cathy

We’re excited to be in the middle of rolling out an expansion of coverage to nearly all of Oregon’s uninsured kids. We’ve expanded coverage to children in families up to 300% of the FPL, with the ability for families above that income limit to buy into the program at full cost. We’ve also streamlined our application, reduced administrative barriers to enrollment, and created a new office dedicated to rolling out an aggressive outreach and marketing campaign. Thanks to all of these changes, we expect to enroll about 80,000 more children into our child health coverage program, Healthy Kids, by the end of this year. Our goal is that at least 95% of all Oregon children have health coverage.

CCF

How was the state able to achieve this goal given the tough fiscal issues facing the state?

Cathy

Well, like every other state, Oregon has been reeling from the economic crisis. We’ve had to cut budgets at the same time we’ve seen people turn to the state for help in record numbers. Fortunately, Oregon is weathering the storm. We’ve protected essential services through a modest tax increase on wealthy individuals and profitable corporations. We’ve also taken steps to begin to address the health care crisis here at the state level. The tough economy has pushed us to recognize now is the time to bring down the price of health care for everybody.

Expanding coverage to children is the first step in this effort. Children without health coverage are far more likely to go without regular, preventive care and to end up getting expensive treatment in an emergency room instead. The cost of covering children is relatively inexpensive compared to the cost of letting them remain uninsured. It will also yield economic benefits over a lifetime. Preventing illness and keeping kids healthy improves school performance and leads to more success in adulthood.

In order to fund this historic expansion for kids, the Oregon legislature passed an increased tax on insurance providers and hospitals. This new revenue, along with all of the federal matching funds it draws down, will also be used to fund a smaller expansion (about 30,000 more people) in coverage for very low-income adults.

CCF

Not only is this a stable, secure coverage that families won’t lose if they lose a job or get sick, it also provides comprehensive coverage, doesn’t it?

Cathy

Yes, that’s right — Healthy Kids covers all the care kids need, including regular check-ups, prescriptions, dental, vision, mental and behavioral health care. The goal of Healthy Kids is just that: healthy kids.

CCF

How did CHIPRA and increased federal Medicaid funding help you achieve your goals?

Cathy

Without CHIPRA and the increased federal Medicaid investment, Oregon simply wouldn’t be able to expand coverage as aggressively as we are. CHIPRA and Medicaid funding provided us the building blocks for creating a program we’re very proud of.

CCF

We’ve heard that you’ve already enrolled 30,700 children in the short time the expansion has been in effect. That is really remarkable. How did you manage to accomplish such a feat?

Cathy

Actually, Liz, we’ve enrolled 30,755 more kids and we’re excited about every last one of them, in case that isn’t obvious! We are well on our way to achieving our enrollment goal. Our success thus far is due to the steps we’ve taken to make it easier for families to apply, which include creating an online application form, eliminating the asset test, and reducing the required period of uninsurance from 6 months down to 2 months. All children now have 12 months of continuous coverage, which has also helped because it means we aren’t losing children when we shouldn’t be. But the fact that we’re doing even better than we hoped to be by this point speaks to the fabulous work our outreach staff is doing and the strong partnerships we’ve developed with community based organizations around the state.

CCF

We’ve also heard some great things about your really innovative outreach activities and were wondering if you could share the highlights with our readers?

Cathy

I’d be happy to! We’ve got a number of great efforts underway. We have a well-funded Application Assistance program, through which certified organizations from local communities will receive $50 for every application they’ve helped a family fill out that results in at least one child enrolling in Healthy Kids. We are also distributing over $3 million in outreach grants to community-based organizations across the state. We are developing targeted campaigns, including a campaign for school coaches and athletic directors to help us reach out to student athletes who need health coverage in order to play sports. We also have a faith-based campaign through which we’re reaching out to a wide variety of faith communities to help spread the word about Healthy Kids to more families.

We are also rolling out an aggressive paid media campaign — in fact, we’ve just placed a large buy of transportation ads, billboards, and radio spots. And we have gorgeous materials, with what I believe is the cutest logo around.

We’re also working to make sure our outreach materials in languages other than English aren’t just translations — that they’re actually created in the language.

I think what’s at the heart of our innovative outreach efforts is the overall approach we’re taking. We’re running the Healthy Kids campaign just like a political campaign or get out the vote campaign. And just like that kind of a campaign, we have paid outreach staff working in the field in local communities and a paid marketing campaign. But we also have an aggressive grassroots, volunteer campaign. Hundreds of volunteer organizations have joined with us to spread the word about Healthy Kids. We work hard to provide them the materials, training and support they need to be effective volunteers on our behalf. We also work hard to get earned media, news coverage that doesn’t cost us anything, but really helps spread the word.

CCF

Cathy, that is really amazing. Oregon is putting a lot of effort into making sure children and families know about their health coverage choices. This plan also provides a health coverage option to uninsured children from middle-class families. Did you find any resistance to that part of the plan and if so, how did you help people understand the need to help the middle class?

Cathy

You know, so many people struggle to afford health coverage these days, we really haven’t had any pushback on this part of the program. In fact, we’ve had the opposite response: people are saying “well, finally!” Oregonians are particularly supportive of Healthy Kids in this time of economic crisis, when more and more parents are losing their jobs or losing their coverage because businesses can’t afford the astronomical growth in premiums.

CCF

You recently announced a partnership with private insurance companies to help provide consumers with more choices through KidsConnect. Can you tell us a little more about that initiative?

Cathy

Yes, Healthy KidsConnect is an important component of Healthy Kids. This is the new, low-cost buy-in portion of our program for moderate income families (between 200% and 300% of the FPL). Families above the income limit are able to buy in to the program at full cost. Coverage provided through KidsConnect is just as comprehensive as our no-cost coverage for families under 200% of the FPL. And in nearly every part of the state, families will have the choice of a statewide carrier or a regional carrier. We’re excited to roll out this program — we begin enrolling children in coverage this month.

CCF

Finally, do you have any advice for other states that might want to follow Oregon’s example?

Cathy

I think effective outreach hinges on three things: a dedicated state office responsible for meeting clear outreach and enrollment goals; sufficient funding (and identifying a good revenue source); and an effective means of engaging community partners in the campaign. In Oregon, we’re lucky to have all three.

CCF

Thanks for taking the time to share your insights on this hugely successful initiative.