Insuring children

The Maine Commission on Children’s Health Care presented a sensible proposal recently to provide more children with health coverage, an act that is both good for the kids and good for the state. One of the challenges for the plan, however, is to persuade families to use it.

The commission, formed after legislative gridlock over the issue last spring, recommended that the state expand its Medicaid coverage of children to the working poor. Expanding that system spares Maine the expense of creating a new bureaucracy and leverages federal dollars, at a 3-to-1 match, so that the state’s contribution of $16 million, raised through the new cigarette tax, would offer more than 15,000 additional children proper health care. This is approximately half the number of children in Maine who currently lack care. An additional benefit of qualifying Maine children now under Medicaid is that they will be protected in the event Congress loses interest in health insurance in the future and cuts its other health programs.

As with the rest of the Medicaid program, the proposal provides for easier access for younger children. This makes sense for limited resources. Providing early preventive care allows doctors to detect and treat illnesses before they become more serious. It can give a poor child the same healthy start as one who is better off. The commission’s plan is generous: Even teens up to age 18 whose parents make less than 185 percent of the poverty level — $24,661 annually for a family of three — can receive health care through this program, although the families earning above 150 percent of poverty would pay a small premium.

Key to making the current and expanded programs work, however, is getting families to sign up. At a conference last October in Maine, Jocelyn Guyer of the Center on Budget and Policy Priorities in Washington estimated that one-third of uninsured children already are eligible for Medicaid, but were not enrolled in the program.

That calls for changes in the way Medicaid is presented to the public. The impression is that only the absolutely destitute qualify for the program, although this is not the case. The commission’s proposal is an opportunity to advertise that children across a fairly wide economic range qualify for Medicaid and that its preventive care is the best way to keep kids healthy and in school to give them a chance to succeed.

That helps everyone. Though lawmakers are sure to debate the income level at which Medicaid should begin — is 185 percent of poverty or 175 percent the better figure? — the overall program should stand up to scrutiny. The proposal deserves strong support in the Legislature.