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New York fills gap between insurance, Medicaid
May 26, 1997
Web posted at: 8:15 p.m. EDT (0015 GMT)From Correspondent Brian Jenkins
NEW YORK (CNN) -- Five-year-old Alycia Taylor had a routine check-up, but her family won't get the bill. The state of New York will pick up the tab through a program called Child Health Plus.
Launched six years ago, Child Health Plus now covers 120,000 children such as Alycia, whose parents earn up to $35,000 a year - too much to qualify for Medicaid, but not enough to make private health insurance affordable.
"... We're a family of four, and both my husband and I -- we don't have coverage because we have jobs that don't provide the coverage," Mrs. Taylor said.
"I've checked out a lot of places, and the coverage is rent for a month -- and we can't afford to do that."
The Taylors can afford Child Health Plus. The yearly premium of $25 per child pays for all "outpatient" care, including doctor visits, immunizations, lab tests and pharmacy bills.
Costly proposition for some
For about 10 million children in the United States, a trip to the doctor can mean a serious drain on the family budget.
About a dozen states have already set up programs to help cover uninsured children, and New York's program has won praise as the biggest and perhaps the best.
The new federal budget deal also calls for an extra $16 billion to be spent over the next five years on health care for children.
The New York program pleases doctors. "I know that I don't have to limit the kind of medication I have to use for a patient," said Dr. Judith Flores, Alycia's physician. "I don't have to worry that someone doesn't have the money for the prescription."
Although Child Health Plus is widely considered a success, it currently covers only a fifth of New York's uninsured children. The program costs New York taxpayers about $100 million per year, more than $800 per child. And it has some limits.
"The package is also smaller than what many working families need. It doesn't include dental care. It doesn't include eye care," said Melinda Dutton of the Children's Defense Fund.
But the state is working to expand the coverage.
"It's a balancing act to provide the best possible range of health care services at the lowest possible cost," said Republican Gov. George Pataki.
New York recently raised the age ceiling for Child Health Plus coverage from six to 18, and by July, the program will also cover hospital stays and major surgery. The state will also be forced to raise the premium some families pay to as much as $150 per year, based on income.
But Maria Rivera says she's willing to pay the price for her son Nathianel.
"His shots are up-to-date, and the doctor sees him all the time," Rivera said. "It's been a very convenient program."
Related stories:
- Democrats want health insurance for children - January 16, 1997
- Health insurance changes become law - August 21, 1996
Related sites:
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- New York State Department of Health
- U.S. Department of Health and Human Services
- Q&A about Health Insurance
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