Short Takes On News & Events

Florida CHIP Program ‘Treading Water’

By Phil Galewitz

September 29th, 2011, 8:47 AM

Despite the tough economy, Florida’s Children’s Health Insurance Program added just 2,000 children in the year ended June 30, for a growth rate of less than 1 percent. Among school-age kids, the program added just 700 children.

Before last year, the Florida CHIP progam was growing by about 8 percent a year. It now has about 275,000 kids enrolled.

Rich Robleto, executive director of Florida Healthy Kids Corp., which runs the low-income health insurance program for children who don’t qualify for Medicaid, cites two factors. He said each month the CHIP program loses up to 8,000 children who transfer to Medicaid because their parents’ income fell; Medicaid added 98,000 children last year.

In addition, Robleto said, a new federal rule requires parents to provide proof they are United States citizens before children can be covered. The documention requirement caused about 10,000 kids to drop off CHIP, he said.

Florida has limited dollars to advertise the CHIP program, and Robleto said many families who lost health coverage during the economic downturn are not familiar with the government program. He said the program is trying to find both children who are eligible and have not been insured and children who have recently lost private coverage because their parents lost their jobs. Florida and two other states account for 40 percent of the 5 million children who are eligible for Medicaid or CHIP but not enrolled. The other states are California and Texas.

“It’s almost as if we are treading water,” he said.

More than 5 million children are enrolled in CHIP across the country.

11 Responses to “Florida CHIP Program ‘Treading Water’”

  1. Cogent Observer says:

    Whether by design or omission, this story omits two important, and probably interconnected factors.

    1. Irrespective of the “for the children” tone, the fact remains that many of the applicants for assistance are not US Citizens, or cannot document that they are. The children, or their parents, have entered this country illegally. If they have made no efforts to comply with immigration law, they are not entitled to public benefits. Yes, the child may go without medical care because of the actions of the parents. However, the child is being taught a more far-reaching lesson by the parents: that he/she may willingly disobey the law (in this case, immigration), and reap no harm. The answer is to have these people navifate the proper channels to achieve citizenship. When they do, if they still need help, they will have at least attained a baseline entitlement to it.

    2. I was reluctant to use the term “entitlement” above. However, the availability of the services is a part of existing law, and I suppose people who are legally in the country should be able to access it for now.

    However, with respect to Medicaid, make no mistake that the program is one of welfare. One would hope that current recipients tried to avoid it, and that they continue to try to extricate themselves from it. By the looks of things, though, it is a hole that saps desire and iniative for betterment of self. Stated otherwise, it is a system from which relatively few successfully emerge. In fact, careers have been made by advocating for the broadening of the “welfare state” and for “welfare rights”.

    Few ask where the money for this comes. The answer is that it comes from a kind of confiscation (stealing) from others. That is more politely referred to as taxation.

    Has anyone thought about the interplay between the sapping of initiative of the welfare recipient, and the confiscation of wealth from the payer? The common denominator between the two is the Government. Perhaps, just perhaps, the recipients of the government largesse, and the financiers of it will recognize that at some point their paths may cross. When that happens, the producers of wealth may decide that it just does not make sense any more to work and to risk and to innovate as they one did. What, then, will happen to everything else?

    Please just think about it..

  2. SteveH says:

    “By the looks of things, though, it is a hole that saps desire and iniative for betterment of self.”
    I’d be willing to bet that this isn’t an observation based on first-hand experience with Medicaid or any other “welfare” system in the US.

    “The answer is that it comes from a kind of confiscation (stealing) from others. That is more politely referred to as taxation.”

    Taxation is not theft. But I suppose convincing yourself that is so provides a level of psychic satisfaction that is important to your mental health. You can think of that as a kind of “welfare system” since public taxation provides this boost to you.

  3. Cogent Observer says:

    SteveH disagrees that taxation amounts to theft. However, no facts, or even theories, are offered in support of his disagreement. Instead, he prefers to cast stones.

    Theft is the taking of property of another without the owner’s consent. Whether or not the reason is “just” (some argue that redistribution of wealth is a “just” reason), the nature of theft remains the same. An indigent person taking food without paying for it from a grocer is no less a thief than a wealthy person stealing a gem from a jeweler.

    Arguments based upon moral relativism like this are disingenuous at best, and dangerous at worst. SteveH would likely be up in arms were someone to break into his home and steal his property. It is not hard to imagine that he, properly, would wish the perpetrator charged, tried, and punished if found guilty. Stated otherwise, he would want the law applied as written and intended. It would not matter if the thief wanted Steve’s property for his child’s bedroom, or to take to a flea market to sell for cash to support a drug habit.

    Issues such as those raised in the article must be viewed in the same way. That is, we must view facts and behaviors as having an objective reality and triggering objective, discernible results. We know what the results are likely to be from looking at what they have historically been. The question then becomes whether it is reasonable to expect a different result this time, or next time, or the time after that.

  4. not.important says:

    Cogent Observer stated “We know what the results are likely to be from looking at what they have historically been. The question then becomes whether it is reasonable to expect a different result this time, or next time, or the time after that.”

    My response is a quote from Kenneth Jenkins. “If you do what you always did, you will get what you always got.”

  5. Dr Mickster says:

    Cogent Observer is, as is often the case, completely misinformed about Medicaid. The vast majority of recipients of Medicaid are working people. There are exceedingly few who are employable yet not seeking employment. Your relativistic moralism smacks of ignorance as in lack of knowledge, not incapable of learning. The “lesson” you refer to is morally repugnant. What ethical good comes from preventing a child getting immunized, having an ear infection or Streptococcal pharyngitis treated in a timely manner? What fiscal benefit comes from the “lesson” that getting care in an Emergency Department is one’s only option? Please keep your high-handed moral lessons to you and yours. Tthe great society that we aspire to be has and will continue to find ways to care about and for the least well-off among us. In closing, who steals more, teaches the worse lesson and causes the most harm: a working illegal immigrant who enrolls their child in CHIP or the Bernie Madoff’s of the world? Who should be taught moral lessons? The key thing to remember is that your lesson to the child has a reasonable chance of letting a child become ill or die. What ethical society could possibly condone that?

  6. Joan Whittemore says:

    Dr. Mickster – AMEN!!

  7. d.d. says:

    Dieing for lack of access to health care is the ultimate lesson.

    Much wiser to be born to well-off parents.

    If all people would just learn this simple path to success in life, our society would be SO much better off.

  8. Involved says:

    The State Children’s Health Insurance Program law was likely the last, best example of compromise — the co-authors of the bill being Senator’s Hatch and Kennedy; who often were so far apart that they were standing back to back. Nonetheless, they understood and they agreed that the ECONOMIC and SOCIAL benefits of insuring children were in their COMMON interests. Research has shown over and over that children who don’t receive care tend to attain lower levels of education; and that a lower level of education tends to result in a lower income status, and that a lower income status results in the utilization of societal ‘safety net’ programs at a higher rate. Through the introduction of a subsidized INSURANCE program; one that in many cases requires co-pays and premium payments on the part of the children’s guardians, this law has sought and has achieved coverage of children to break this cycle. Introduced only in the late 1990′s, we have seen some positive effects from this program on the health/wellness of children as well as a reduction in uncompensated care costs through decreased utilization of disproportionate shares hospital payments.
    These payments to hospitals, because of a Reagan-era law, compensates hospitals at the ‘rack rate’, whereas insured pay a lower, negotiated rate. As such, establishing coverage for children reduces the cost burden of uncompensated care, and the tax burden it place on all from a higher cost rate for covering uncompensated care. By establishing a level of consumerism within the CHIP program, and involving the individuals in the payment of this care, the CHIP law is fundamentally different than Medicaid.
    All in, the lack of awareness of such a program, the lack of funds to generate awareness regarding the program, and the introduction of restrictive access rules to such a program reduces the law’s efficacy and results in a higher cost paid for all.

  9. EBER says:

    I believe Dr Mickster is missuing a significant issue. First, there are many people covered under medicaid who are employed and get coverage under the federal poverty guidelines, but the “VAST MAJORITY” of covered members are children or pregnant woman, and In do not believe that the children are employed.
    The Issue missed is that the regulation which prevents the children being covered under CHIPS was a federal rule that the parents must show documentation of citizenship. Recognized legal aliens are added to the Medicaid roles by the federal government all the time, and the federal government should pay for their care. The concern on the care of the illegal aliens strikes home to the taxpayers as a form of forced charity. I agree the statement about the children being taught a lesson was tactless and silly, but unless Dr Mickster can show me the free healthcare provided for the indigent in the various countries the illegal aliens came from (and I doubt that he can do that), then it would appear they are here for the reason of public charity. It would be better to take the child and their parents into custody of the imigration service (as the law requires) follow the federal laws regarding their disposition (which includes appropriate medical care when they are in custody/detention), and this would resole both issues.

  10. Dr Mickster says:

    Whatever a person’s country of origin, and by the way I don’t support illegal immigration being the son of a firs-generation immigrant who came here legally and attained citizenship, I don’t agree that they are coming here for “public charity”. There are ample data that show that immigrants, both legal and illegal come here to work, period. Its also not free. The vast majority of immigrants contribute to the local economy because no matter what country they may be from, they are spending US dollars. By the way, NO children are employed and or pay for their insurance, poor or not.

    As to the notion that taking millions of into custody, that’s almost not even worth responding too other than to say that removing so many millions from the workforce would guarantee a return to recession as local economies would grind to a halt. Many of our countrymen and women won’t take the wages that are often offered to the undocumented, there’s not enough money in it for them.

    From Kaiser FF State Health Facts.org:
    Medicaid Recipients in the US: 20% children, 12.4% adults 24.7% Elderly and 42.4% Disabled. Tell me which of these groups is it that you think we should jail? My point is that sweeping generalizations are at best ridiculous, and at worst dangerous. We need to start offering practical, not ideological solutions. I don’t think illegal immigrants should have the same benefits that citizens do, without paying what we do for them, namely taxes. Many, many illegal immigrants do. Not all, certainly and citizens who hire them should precede their known illegal employees to jail, in my view, because they’re only motivation seems to be personal profit. Its cheaper to hire an illegal immigrant for whom you don’t pay payroll taxes, FICA, Soc Security or support a health plan, but depending on the state, they could.

    How about we stop talking about ANY solution that risks someones’ life or health and think about how to let people participate in transparent way?

  11. AnnieG says:

    Let’s back up a minute. Illegal immigranst know very well that if they come to the US and have an Anchor baby, they and their household qualify for benefits. Part of the problem with all of these programs is the mother not getting married to collect more benefits while living with the children’s father, many of whom are working for cash. It’s their cheating the system that is hurting their children. Blame them, not taxpayers.
    Call it harsh, but our coffers are being drained dry. Let them buy into the system.
    At this point having children, whether you are an illegal or US citizen, is an occupation. The more kids, the bigger reward.
    If you think not, try being a single person or senior without dependents and try asking for any assistance.

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