Hawaii may be first to insure all kids

A bill that would provide free health insurance to children is "well on its way"

No child left uninsured is the goal of state and private officials working on programs to provide medical coverage to the estimated 16,000 children without such insurance.

"There isn't any excuse for pretty much anybody not to have a kid insured now," said Beth Giesting, Hawaii State Primary Care Association executive director.

The changes resulting from and proposed by state and federal government action include:

» A bill moving through the Legislature for a Keiki Care Plan that would provide free health insurance to children in families who do not qualify for the state's QUEST program but cannot afford private insurance.

» A federal increase in income limits for families earning up to 200 percent of the federal poverty level to qualify for the state's free QUEST and Medicaid programs.

» Expansion of the QUEST program to provide health care insurance for an additional 29,000 residents and increase income eligibility by 50 percent, allowing families who make up to 250 percent of the federal poverty level to obtain coverage.

The House Health Committee approved House Bill 3116 yesterday to establish the Keiki Care Plan as a three-year pilot program in partnership with a mutual benefit society, such as the Hawaii Medical Service Association. HMSA has a children's health plan that would be a model for the pilot program, according to the legislation.

The plan's goal is to provide health insurance for all children in Hawaii, said Rep. Josh Green (D, North Kona-Keauhou-Kailua-Kona-Honokohau), Health Committee vice chairman.

Hawaii would be the first state to insure all of its children if the bill passes, "and it's well on its way," he said yesterday in an interview. "We have buy-in from the Senate."

Green, a medical doctor, said the state would pay half the premiums for the children, and the private partner would pay the other half of the cost.

The Hawaii Uninsured Project estimates about 16,000 uninsured children in the islands.

About half qualify for Medicaid health benefits because of the boost of eligibility limits to 200 percent of the federal poverty level, and an additional 3,000 might be among new members covered with recent expansion of QUEST, Green said.

"That still leaves several thousand not covered," Green said, noting that the remaining 5,000 children could be covered by the Keiki Care Plan and the increase in eligibility income limits to 250 percent of the federal poverty level.

Giving children a healthy start "will result in fewer health problems and lower health-care costs as they grow to be adults, and the state will benefit in the long term," House Health Chairman Dennis Arakaki (D, Alewa Heights-Kalihi Valley-Fort Shafter) said in a news release.

HMSA Executive Vice President Gwen Miyasato said in the news release that the proposed keiki program "is an investment in the future health of our community."

Green said the bill was drafted before the state learned last week that the federal government had approved expanding QUEST.

Before the federal action, the Keiki Care Program was estimated to cost about $4 million, divided between the state and the private partner, and now it will be less than $1 million each, he said.

The Centers for Medicare and Medicaid Services increased eligibility and lowered monthly premiums for children of families earning more than 250 percent of the federal poverty level (about $4,637 a month for a four-member family).

State Department of Human Services officials said they expect more than $100 million in extra Medicaid money in the next six years to cover the costs.

Hawaii Covering Kids, a Hawaii State Primary Care Association project, has announced federal increases in this year's family income limits for the state's free QUEST and Medicaid Programs.

A family of four earning up to $46,000 annually (200 percent of the Federal Poverty Level) is now eligible for free insurance for their children, said Barbara Luksch, project director. "That is $1,480 more than the 2005 limit for a family of four," Luksch said.

The Keiki Care Plan would cover preventive services, immunizations, doctor visits, diagnostic tests, dental services, mental health benefits and dental services, with limited coverage for prescription drugs, the bill says.

"One more option is good," Giesting said, noting that even with reduced premiums under the QUEST expansion, some low-income families with a number of children might not be able to pay them.

"They would have a choice of getting into this (Keiki Care) program, which would be free."

MORE INFORMATION More information about the free Medicaid and QUEST plans and applications are available at www.coveringkids.com. Parents and guardians also can call 211 free from all islands to obtain an application by mail.