More kids uninsured, but parents can get help (SC)

The ailing economy and high insurance costs have left more children without coverage, but there are some options, including a basic low-cost plan offered through the school district.

Since 2000, nearly 9 million Americans have lost their health insurance, with moderate-income families hardest hit, The Commonwealth Fund reports.

In South Carolina, the number of uninsured children swelled from 87,000 in 2004 to 152,000 in 2007, according to new census data.

Many children are on Medicaid, and their numbers grew from 393,208 in June 2007 to 407,043 in June 2008, according to Jeff Stensland, spokesman for the state Department of Health and Human Services, which administers the program. But those who aren't eligible often seek health care in expensive hospital emergency rooms or go without.

There is comparatively inexpensive coverage offered through Greenville County Schools, said spokesman Oby Lyles. Sold by UnitedHealthcare, accident insurance costs between $11 and $75 a year, depending on the plan. Insurance that covers hospitalization, outpatient care and more costs $98 every two months with a $50 deductible.

But in the district, which has nearly 69,000 students, only 366 families signed up last year, said UnitedHealthcare spokesman Roger Rollman.

There could be several reasons for that, said Commonwealth Fund president Karen Davis. First, families may not know about it.

"Even people who are eligible for Medicaid aren't aware of it," she said, "and that's free."

About a quarter of uninsured children are eligible, according to the Kaiser Family Foundation. In South Carolina, that would be about 38,000 children, though others set that number at 70,000.

UnitedHealthcare typically provides schools with brochures and enrollment forms to give parents, Rollman said via e-mail. This year, he said, there's a direct mailing.

"What we have found is that K-12 health coverage is often purchased by parents who have existing high-deductible coverage through their employers and who want this school-based low-deductible coverage for their children," he said.

Other reasons so few sign up could be a perception that insurance is out of reach, Davis said, or families may be focused on other things, such as child care. But others still may not have the money, she said, noting most uninsured children live in families where one or both parents work.

"If you've got two kids, that's $100 a month," she said, "and you may not have $100 a month by the time you pay the gas bills and the mortgage."

But Davis said the plan leaves many expenses uncovered, such as allergies, developmental disabilities and pre-existing conditions. So some may not think it's worthwhile.

"The plan limits hospital coverage to $700 a day, yet hospital bills could easily exceed that," she said. "Prescription drugs are not covered. Dental care is not covered. Preventive care such as immunizations, routine physicals, and newborn infant care is not covered. Overall payments are limited to a maximum of $50,000 per year."

Rollman said the plan provides a measure of coverage that a child would not otherwise have and at a reasonable cost.

Still, four of 10 working-age Americans have problems paying medical bills, The Commonwealth Fund reports. And of the 49 million with medical debt, a quarter owe at least $4,000. And of this group, 29 percent did without food, heat, or rent because of their bills, while 39 percent paid bills with savings and 30 percent used a credit card.

So what else can uninsured families do?

A program called Healthy Connections links uninsured students with medical care, such as community health clinics or doctors who volunteer their services, said director Kim Mahaffey. It also provides case management services, such as finding the children a medical home, making doctor appointments and enrolling eligible kids on Medicaid.

Because it relies on grants as well as funding from the United Way and Bon Secours St. Francis Health System, the program currently operates only in Tanglewood and Lakeview middle schools, she said. Last year, it served 445 students.

Tom Moran, director of the medical center clinics for Greenville Hospital System University Medical Center, says its pediatric clinics care for 31,000 children. And while more than 80 percent are on Medicaid, no one is turned away. The uninsured are treated and enrolled in Medicaid if they're eligible, he said, or moved to a community health center like New Horizon Family Health Service, which has a sliding scale for care depending on income.

While it doesn't have a pediatric clinic, St. Francis finds care for uninsured children who show up at the hospital and enrolls eligible children on Medicaid, said spokeswoman Lee Turza. It also co-sponsors community services that provide health care to children, such as a mobile dental unit that served 1,400 children in the past year, said Lori P. Center, director of community ministries.

For those who need more extensive care, there is New Horizon Family Dental Care, which provides treatment on a sliding scale. And Communicare, a public-private partnership, provides donated medication to the working uninsured and dental care for children of low-income families.

The state Department of Health and Environmental Control provides free immunizations to children with no insurance, spokesman Thom Berry said via e-mail. And its Children's Rehabilitative Services Program offers medical evaluation, treatment and related services to eligible children for certain conditions, such as diabetes.

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