Children’s Defense Fund Minnesota: Group pushes health care for kids

A girl newly diagnosed as a diabetic came to the attention of Bemidji school authorities Friday, says Susan Nokleby, Bemidji School District’s sole full-time registered nurse.
“Talking to her dad today, I also found out mom is a Type II diabetic, and (they) have no health insurance,” Nokleby said. “They’re trying to figure out the cheapest way they can do to manage this diabetes for this girl to keep her healthy.
“It’s some decisions people shouldn’t have to face, but it is fairly common that we see kids who aren’t insured,” she said.
It’s all too common throughout Minnesota, says Jim Koppel, director of Children’s Defense Fund Minnesota, who notes that as of 2007 there were 85,000 children in Minnesota who don’t have health insurance — up 20 ,000 in eight years.
“We’re concerned statewide about health care coverage for children, but we’re here in Bemidji to talk specifically about what it means here, what it means in greater Minnesota and what we can do about it,” says Koppel.
Koppel and Nokleby were joined Friday afternoon by Minnesota House Health and Human Services Chairman Paul Thissen, DFL-Minneapolis, and local legislators at a news conference in the J.W. Smith Elementary School library.
“This is front-end, taking care of the kids so they stay healthy, so they learn better,” said Nokleby. “School nurses have really identified that healthier kids learn better. It’s obvious to us. “
Healthy students track better academically, she said, “they’ll go through the educational process better. They’re probably not going to go into the criminal justice system if they have an education.”
Kids without health coverage are 25 percent more likely to miss school than insured children, said Koppel. “IF they are not in school, they won’t succeed.”
In northwest Minnesota, more than 8 percent of the children don’t have health care coverage, Koppel said. That’s only exceeded by northeast Minnesota, where more than 9 percent of kids don’t have health insurance.
The rising cost of health care premiums is also affecting families, Nokleby said, as parents may not be able to afford the health insurance offered where they work, but also make too much to qualify for public assisted health care, either MinnesotaCare or Medical Assistance.
“It’s putting a lot of pressure on our school systems to deliver services that should be delivered elsewhere, and more effectively delivered elsewhere,” said Thissen, adding that school nurses often are the first-line of defense in children’s health issues if the family has no health insurance.
Thissen outlined his agenda for health care for the 2009 session.
With the state facing up to a $2 billion state budget deficit next biennium, Thissen said it’s important that lawmakers in 2009 at least hold the line in subsidized health care, not to add to the 85,000 uninsured kids today.
“In the last two years, we made some progress in moving that forward,,” he said. “By 2011, the estimates are we will insure about 37,000 of those kids. … We want to make sure we don’t go backwards.”
And, probably a majority of the kids who remain uninsured qualify for a number of programs, so parents need to know that and government red tape to get on those programs needs to be eased, he said.
“We want to make sure those kids get enrolled, and we want to get rid of the bureaucratic red tape that prevents that from happening,” said Thissen. “That’s going to be a real focus in the next session.”
It would mean expanding coverage but not through adjusted income levels or changing eligibility requirements, “but by just getting rid of the red tape and getting people enrolled,” he said.
Also, “it’s not just a legislative/government responsibility to take care of this,” Thissen said. “It’s back-to-school time and one of the things we want to make sure as families is getting ready for school, filling their backpacks with pencils and pens and all the things you need,. Another thing that needs to go in the kids’ backpack is health insurance.”
Having health insurance is one of the key indicators and factors of success in school, he said. “The Legislature has a responsibility to make sure that assistance is available for families.”
Many families cannot afford family insurance through work, he said, noting that 250,000 Minnesotans pay more than 25 percent of their income on health care. “The affordability problem is something the Legislature has to solve, but there’s also a community and individual family responsibility to take advantage of what we have now.”
Thissen and Koppel said two different Web sites offer families information about health care.
One site, www.bridgetobenefits.org, has a checklist to determine roughly eligibility for a number of public assistance programs, tax credits and child care assistance. Another site, www.healthcareformn.org, has information about Thissen’s health care reform proposals.
Rep. Brita Sailer, DFL-Park Rapids, who is seeking a third term, said she has found door-knocking that many families can’t afford health insurance and it’s an issue. She’s also found that many give up on the paperwork to find out if they are eligible for public assistance and the lag time before getting the aid.
“It’s just something we’ve got to do,” said Sailer. “Putting more kids on MinnesotaCare was really an important thing. I’m really glad that we were able to, to start moving forward.”
“We hear this again and again — so many families can’t insure their kids, they can’t afford,” said Assistant House Majority Leader Frank Moe, DFL-Bemidji, who isn’t seeking re-election this fall. “Do you choose between groceries and insurance for your kids? Or gas for your car to get you to work, which might be 30 miles away?”
Thissen, when asked, admitted that putting more kids on health insurance is only part of total health care reform. Adding public assistance patients will burden health providers who don’t receive reimbursement that equals costs.
“We do have to deal with provider rate issues,” Thissen said, adding that a bill he authored in 2007 does increase provider rates for treating children.
But he also says it is important for the future of children’s health to insure them and is a higher priority than fully funding hospital reimbursements. Plus, he said, families with no insurance will leave providers with higher debt through uncompensated care.
“Providers may see fewer public assistance children,” Koppel said. “After MinnesotaCare passed in the 1990s, we saw a huge decrease both in charity care and in unnecessary hospitalizations because people got better care.”