Covering kids

February 23, 2001

Heather Heilman

The Louisiana Children's Health Insurance Program offers top- quality comprehensive health insurance:which covers immunizations, regular checkups, vision and dental care, prescriptions, hospitalizations, even mental health care: for free.

There are no premiums, deductibles or out-of-pocket expenses. There's only one problem. It seems too good to be true, so many families who qualify for LaCHIP assume they're not eligible.

"When you talk about free health care, a lot of people don't believe it," said Dan Payne, a doctoral student in the School of Public Health and Tropical Medicine. "Many working families have no idea that they're eligible."

In fact, however, any Louisiana family that earns up to 200 percent of the federal poverty level can receive insurance for their children under 19 if they're not insured already. A family of four, for example, can have an income of up to $34,000 and still qualify. The new, higher income levels went into effect in January.

Payne also is the Louisiana project director of the Covering Kids Initiative, which aims to boost enrollment in LaCHIP. He is just one member of the Tulane community who is working to achieve that goal. "We are actively involved in spreading the word to the public," said Neil Boris, assistant professor of community health sciences, who works with Tulane students on outreach efforts.

One of those students is Tami Lyn Fleming, who is working on her master's in public health. She has organized efforts to enroll children who live in and around the St. Thomas housing development, where she grew up. Her groups of "Walkers and Talkers" are local residents who go door-to-door to sign up families. They've had great success in a neighborhood where people tend to be suspicious of government programs.

Tulane students also have worked on outreach efforts in the Iberville housing development. Others have targeted the Hispanic community, making presentations in Spanish and soothing worries about participating. In the two years that LaCHIP has been in place, five graduate students from the community health department have done their capstones on LaCHIP-related projects.

"It's practical public health experience," said Boris. But public health students and faculty aren't the only ones at Tulane who have been involved with LaCHIP. Medical school students have made presentations about LaCHIP at parent-teacher association meetings in area schools. And a group of 40 Tulane and Louisiana State University medical students handed out a thousand applications as part of a campaign at New Orleans K-Marts last month.

John Lewy, chair of pediatrics, will help kickoff efforts for a media campaign that will begin March 14 at the Reily Pavilion of Tulane Hospital. "What is needed depends on what segment of the community you're looking at," said Boris. Some families need reassurance that the forms aren't difficult to fill out or ask for intrusive information. Others need to know where to find participating doctors and other providers. Still others have never heard of the program and have no idea that they qualify.

The new income levels mean that approximately 30,000 more children qualify for coverage this year. While there are thousands of eligible children left to enroll, LaCHIP has been an enormous success in Louisiana, helping to lift the state from the bottom of the list of percentages of children who are insured in each state. More than 100,000 previously uninsured children are now covered, and the state is ranked fifth in the nation for increasing coverage for children since the inception of the program.

"Louisiana is doing a good job," said Payne. "It's rather shocking for people who are used to seeing us on the bottom."

Each state has a CHIP program, which was designed to help working families who earn too much to qualify for Medicaid but who can't afford to buy insurance on their own or through their employer. Most of the funding comes from the federal government, but states are required to match a portion of the funds. Despite the state's budget problems, continued support of the program seems assured, in part because Sen. John Breaux is a strong advocate for it.

"It's a moral imperative, and it's an investment," said Boris. "Kids who don't get regular care get sick more often, and it can affect their school performance and cause other problems down the line."

Tulane University, New Orleans, LA 70118 504-865-5000