By Robin Christian, Children First for Oregon
In this time of economic uncertainty and political division, last week brought us some welcome good news in Oregon.
According to the Oregon Health Authority, the number of uninsured children has dropped dramatically in less than two years – from 11.3% to 5.6% – thanks to the affordable, quality health insurance provided by the Oregon Healthy Kids initiative. This puts Oregon on the leading edge of efforts to connect kids with coverage and shows how a little forward thinking can create better outcomes for children.
Oregon Healthy Kids is free or low-cost health care coverage for Oregon children and teens. Currently, all uninsured Oregon children living in families who make less than $44,000 a year for a family of four (200% FPL) may be eligible to receive no-cost health coverage through Healthy Kids. Children in families of four making as much as $66,000 a year (300% FPL) may be eligible for low-cost coverage through the program, and children in families of four making above that amount are able to buy into this high-quality, comprehensive program.
But as you can imagine, just making coverage available was not enough to ensure that 94,000 previously uninsured children would have access to a doctor’s care. Instead, the Healthy Kids initiative has been successful because it combines extensive outreach efforts with the hard work needed to reduce unnecessary barriers to enrollment.
The Office of Healthy Kids, in partnership with Children First for Oregon, ran a well-coordinated campaign, using focus groups, marketing firms, and “boots on the ground” efforts. Groups of families with children currently enrolled or potentially eligible helped revise the Healthy Kids application, ensuring the language would be easily understandable to the intended audience. Culturally specific materials and marketing were developed by small marketing firms that were familiar with Oregon’s various ethnic groups. State staff coordinated outreach efforts regionally and throughout Oregon schools to utilize and support the application assistors and outreach grantees that live throughout the state.
The Office of Healthy Kids also revised the application, removing unnecessary “required” information and utilizing existing information sources for eligibility determination. The application was revised to reduce income documentation requirements to one pay-stub and one parent’s signature instead of two. Oregon now uses existing data for citizenship and income verification, such as income information provided through the Supplemental Nutritional Assistance Program (SNAP) and Free & Reduced School Meal programs, as well as Social Security Administration data on citizenship. Using data from these systems reduces the number of pended applications and the amount of additional information that applicants must provide. The SNAP income data also helps identify children who are likely eligible for Healthy Kids but are not yet enrolled. Their families are mailed short application forms with pre-populated income information, notifying them that their children can be “express-laned” into Healthy Kids.
And yet, as the federal budget negotiations drag on, the budget axe is threatening to cut into Oregon’s success. Some proposals in Congress would roll back funding for Medicaid by as much as 33 percent, which could undermine health care coverage for up to 56% percent of Oregon’s currently enrolled children. This is exactly the wrong time for Congress to cut off funding for children’s health care. The federal government must address the deficit, but taking health care away from the 94,000 families and children enrolled in Oregon Healthy Kids in the last two years would be the wrong approach.
(Robin is also the former Chair of the Kids Count National Steering Committee for the Annie E. Casey foundation.)
