Plan fuses insurance programs for children

OLYMPIA – Pressing ahead with Democrats’ goal of health coverage for all Washington children by 2010, state Sen. Chris Marr wants to combine several state medical programs into one streamlined system covering children from low- and moderate-income families.

Healthier kids mean better students and productive lives, said Marr, D-Spokane, whose bill aims to add tens of thousands more children to the state’s network of medical programs. Regular care means they won’t be showing up for expensive treatment at hospital emergency rooms, he said.

Some Republicans worry about the cost, however. Marr’s proposal would cover children in families that earn up to 250 percent of the federal poverty level. For a family of four, that’s $50,000 a year. (Those earning more than $40,000 would have to pay part or all of the state’s cost.)

“That’s a lot of money where I live in Eastern Washington,” said Sen. Linda Evans Parlette, R-Wenatchee.

State Sen. Cheryl Pflug, R-Maple Valley, said some advocates are pushing for coverage for families earning up to 300 percent of the poverty level, which would be $60,000 a year.

Pflug said she’s also uneasy about the emphasis on children, who make up an estimated 4.4 percent of the uninsured residents in the state. People ages 19 to 34 account for more than half of the uninsured, she said.

Marr’s proposal, however, has good odds. He’s spearheading it in the Senate – there’s also a House version – on behalf of Gov. Chris Gregoire. In December, Gregoire proposed adding 32,000 children to state-subsidized health insurance, a move that would cost about $60 million. Gregoire is also pushing for a $29 million increase in payments to pediatricians who treat children from low-income families.

“That will make a major difference in helping the pediatricians to stay solvent,” said Dr. Chris Olson, a Spokane pediatrician who testified in Olympia on Monday in favor of Marr’s bill.

More than 572,000 children – about 35 percent – are covered by state-sponsored health insurance in Washington. Medicaid covers those with family incomes below 200 percent of poverty level, or $40,000 for a family of four. The state Children’s Health Insurance Program covers those between 200 percent and 250 percent of the poverty level. And the Children’s Health Program covers below-poverty-level children ineligible for Medicaid, such as illegal immigrants.

Under Senate Bill 5093 from Marr and the governor, children with family incomes between 200 percent and 250 percent of the poverty level – $40,000 to $50,000 for a family of four – would have to pay premiums for their coverage.

Parents with incomes above 250 percent of poverty level could enroll in the program but would have to pay the full cost. The bill also requires parents with employer-sponsored insurance to enroll their kids there, if that’s cheaper for the state.

“The state should not be responsible for paying for Bill Gates’ children,” said Christina Hulet, a policy adviser to Gregoire.

At a time when the overall number of uninsured rose, children have been a rare bright spot. In 1993, according to state estimates, 11.4 percent of kids in Washington were uninsured, compared with today’s 4.4 percent.

“Now you’re down to the hard part: finding those kids who are not easy to find,” Len McComb, a state hospital association lobbyist, told lawmakers Monday.

The state estimates that nearly 63 percent of uninsured children in Washington may actually be eligible for coverage; their parents just don’t know it. To get the word out, the state is considering expanding outreach and education efforts.

Sen. Steve Hobbs, D-Lake Stevens, has also proposed SB 5100, which would require schools to ask all parents whether their children have health insurance. If they say no, or don’t answer, the school would mail information about the state’s Medicaid and Children’s Health Insurance plans to the home.