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Details of CHIP expansion must reach eligible families

The newly enacted expansion of the Pennsylvania Children's Health Insurance Program (CHIP) has put into focus again statistics that deliver an unflattering message about the state's ability to successfully convey important information and ensure that it is acted upon.

The program expansion also reinforces the fact that, despite politicians' desire to put the best face on the state's economy, many families still struggle to provide for their children in some of the most basic ways.

The information returned to the spotlight as a result of the latest CHIP action was a Pennsylvania Insurance Department survey two years ago that found that more than 108,000 state children eligible for subsidized health coverage were not enrolled. They were among more than 133,000 children who lacked health insurance at the time of the survey.

The question that must continue to be asked is, where exactly within the state bureaucracy does the bulk of the blame lie for the lack of coverage that remains today?

The difference between the two numbers from two years ago — 25,000 — was the number of uninsured children who were not eligible for any subsized health coverage. Some of those children, whose parents make too much money for them to qualify for government-sponsored insurance but cannot afford private insurance, would become eligible for CHIP coverage, possibly as early as Jan. 1.

CHIP was created in 1992 to provide free or low-cost health care for children ineligible for welfare health benefits. The newly passed legislation would expand eligibility to children whose families earn up to 300 percent of the federal poverty level — about $60,000 for a family of four — with the stipulation that they pay part of the premium, based on ability to pay. The program currently tops out with families earning 235 percent of the federal poverty level — about $47,000 for a family of four.

The monthly per-child premium under the CHIP expansion would range from $36 to $57.

Another good feature of the just- passed guidelines is that some families who earn above 300 percent of the federal poverty level would be allowed to participate under certain conditions. Those conditions include instances when a family has been refused coverage by private insurers due to a pre-existing condition and if the cost of coverage exceeds 10 percent of family income.

In those cases, the family would be responsible for the full premium.

The state anticipates that about 15,000 currently uninsured children will be enrolled in the expanded program between January and June and that the number will increase to nearly 70,000 within five years.

However, those numbers could increase markedly if the state and various agencies would do a better job in getting the word out about the new insurance availability and make more help available to those experiencing difficulty or reluctance regarding the application process.

The state General Assembly, which hasn't delivered very many success stories during the past two years, should get good marks for its CHIP action. Under that action, the way was paved for Pennsylvania to become only the second state in the nation to offer health-insurance benefits to all uninsured children.

Illinois was the first state to do so, effective July 1 of this year.

Although the insurance action won't eliminate all of the economic challenges facing hard-pressed Pennsylvania families, it is an important ingredient toward the goal of helping them get through their tough times.

But first they must learn about this expansion of coverage.

The executive and legislative branches of the state government should make sure that that happens.

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