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By Pat Bellinghausen

Covering Montana children should be a first step in Montana's effort to reduce the state's high rate of uninsured residents.

Last year, 173,000 Montanans had no health insurance. Among the ranks of the uninsured were 41,500 children. That's 17 percent of all Montanans ages 0-18 -one of the highest children's rates in the nation, according to Steve Seninger, director of Montana Kids Count in Missoula. These numbers are based on extensive research Seninger led last year as an economist with the Bureau of Business and Economic Research at the University of Montana.

Among uninsured Montana children, Seninger calculated that 22,000 are in families below 150 percent of poverty level. (One hundred fifty percent of poverty is $22,530 annual income for a family of three.) All these children would qualify for the Children's Health Insurance Program or Medicaid. Yet they have no coverage.

Mary Noel, who coordinates CHIP in Helena for the Department of Public Health and Human Services, estimates that a third of the uninsured low-income children would qualify for Medicaid and the rest would qualify for CHIP.

As of this month, 11,068 Montana children from babies to age 18 were covered by CHIP. The federal government pays 81 percent of the costs of providing private health insurance coverage for these children who otherwise would have no insurance. These are children whose families aren't poor enough to qualify for Medicaid, but whose income is low so that they cannot afford private insurance. Most are children whose parents work at low-paying jobs.

CHIP enrollment has been limited in Montana by the amount of state matching money appropriated by the Legislature. Last fall, Gov. Judy Martz designated an additional $609,000 from an unexpected federal appropriation to cover an increase in the CHIP costs and the 1,300 kids who were on the CHIP waiting list in October. There hasn't been a waiting list since then. New applications are received monthly and eligible children have been getting insurance coverage starting the first of the next month.

Chuck Hunter, administrator of the Child and Adult Health Resources Division in Helena, said the governor's allocation would allow CHIP to keep covering as many children as it now does through December.

Hunter knows that the research shows that thousands of low-income kids don't have insurance, yet DPHHS hasn't promoted applications for CHIP. "We have not done a huge amount of outreach because the program is capped," he said.

The2003 Legislature approved a plan for CHIP to cover more kids by augmenting the state appropriation with private donations. Every dollar contributed by a private individual will be matched with four dollars from the federal government.

The state of Montana can cover thousands more needy children this year. The public can help. Make a donation. Question your legislative candidates about their support for CHIP. Make it clear that you support this effort to provide a healthy start for Montana children. And spread the word to family, friends and neighbors. CHIP works. Rather than risking a child's health, encourage uninsured families to check into this insurance option for their children.

A child with no health insurance is less likely to receive preventative checkups and immunizations. Parents without insurance are more likely to delay getting care. And when they seek it, they are more likely to use hospital emergency rooms, an expensive substitute for timely clinic visits.

Raising healthy children is its own reward. But there's a financial benefit, too. Montanans pay for preventable health problems. Those who have insurance pay higher premiums because others lack coverage. In Montana, hospitals don't turn away needy patients. But somebody has to pay. If you have insurance, you are paying for everybody.

We all have a stake in making the health care system as efficient and effective as possible. Montanans must CHIP away at obstacles to insurance.

CHIP details

• To make a tax-deductible contribution that will be matched with federal funds to insure Montana children, send checks to: CHIP Fund, P.O. Box 202951, Helena, MT 59620.

• To find out how uninsured children (ages birth to 18) can get CHIP coverage, call toll free (877) 543-7669 (that's 877 KIDSNOW).

• In Yellowstone County, call the Community Health Access Partnership at 247-3290 or Maternal Child Health at 247-3360. Both of these offices are in the Yellowstone City-County Health Department. The health access partnership involves the Health Department, St. Vincent Healthcare and Deaconess Billings Clinic.

Copyright 2004. Used with permission from The Billing Gazette.