Castro: Providing Health Insurance For New Jersey's Kids

The Record ( — Tuesday, September 9, 2008


Our kids' health is every bit as important as their education in both the short and long run. But it's an investment that we as a society have not come together on in the same way as education.

The beginning of the school year is something we've come to view as something natural, like the turning of the fall leaves. Public education is a benefit we can take for granted because long ago we as a society decided to pay for it by pooling everyone's tax dollars.

In New Jersey, that's been the case since 1875, and earlier than that in many states. Few today would question the need for compulsory, universal public education. We make the resources needed to fund it available as a right that reflects one of our highest American ideals, equal opportunity for all. We also know it is an essential investment in our future.

Arguably, our kids' health is every bit as important as their education in both the short and long run. But it's an investment that we as a society have not come together on in the same way as education. We want healthy children, but we haven't reached consensus on the need for everyone to chip in to make sure every child has the same access to health care as he or she does to education.

That situation could be changing for the better. Legislation mandating health insurance for all children by July 2009 recently signed by Governor Corzine marks the beginning of another major era for children that could prove as promising as compulsory public education, and for similar reasons.

But requiring health insurance will be more difficult to accomplish than mandating education for kids. For one thing, health coverage will not be completely covered by tax dollars except for the poor. Everyone else (or their employer), will have to pay, though reduced rates will be available based on economic need. And, unlike education, there will be no penalty for non-compliance, probably a good thing because the full implications of enforcement need further study.

Lacking coverage

Some 13 percent of New Jersey children today lack health insurance. That's higher than the U.S. average, and the number is rising. This comes in spite of the fact that the state's program for insuring low-income kids has the most inclusive eligibility standards in the country. "Build it and they will come" worked for a baseball field in an Iowa corn patch in the movie "Field of Dreams," but in the real world, providing kids with health insurance has proven to be less easy.

Nevertheless, there is reason for more optimism this time around. Both the Corzine administration and the Legislature now recognize that New Jersey must do a better job reaching uninsured children. And establishing a mandate makes it clearer that health coverage for children is not only a priority, it is a right. In a way, it's a natural extension of current rules that require immunizations to get into school. It's recognition that good, regular medical care is critical to preventing diseases and even doing well in school.

The new law specifies what actions must be taken to insure all children. It establishes a working group of outside experts that will advise the state on the best ways to make sure uninsured children and their families find out about opportunities for coverage and to retain the kids once they are enrolled. The working group will also develop monthly enrollment targets with the goal of reaching all children within a specified date. This will bring accountability and transparency that did not exist before.

The law also allocates $1 million for outreach, including a media campaign. That might sound like a no-brainer, but the state has not spent any money on outreach for the past two years, so many families do not even know they are eligible for the various programs that are available.

The new law also restores eligibility for parents in FamilyCare if their income is less than twice the federal poverty level. That's important because studies show that if parents can get in the program, they are more likely to enroll their kids.

But it will take more than words on paper to achieve the laudable goal of insuring all children in New Jersey. The mandate will be meaningless unless the state provides adequate funding each year to subsidize health care coverage for families that cannot afford it, and the federal government lives up to its part of the bargain.

Good news from Washington

Washington provides 65 percent of the funding for FamilyCare. The recent decision by the Bush administration to delay its plans to deny federal funding for health coverage for about 35,000 uninsured moderate-income children in New Jersey is good news, but nothing short of rescinding this mean-spirited policy should be acceptable to the state's congressional delegation.

The public also has a major role to play. The state will advertise kids' health programs more, but research shows that most parents hear about them from their friends and family. So we all need to remind parents of the importance of covering children and that this is no longer an option, but a parental obligation.

Then when we "build it, they will come."

Raymond J. Castro is senior policy analyst at New Jersey Policy Perspective, a non-profit, non-partisan organization in Trenton that conducts research on state issues.

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