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Monday, September 29, 1997

State launches program to help uninsured children get medical care

DALLAS (AP) -- The state of Texas is working to establish by next June a program to help assure medical care for more than one million children from families too rich for Medicaid but too poor for insurance.

The nonprofit organization, called the Texas Healthy Kids Corp., is modeled on a successful plan in Florida, home to about 800,000 uninsured children.

It is being set up under a bill signed into law June 2 by Gov. George W. Bush to help middle-class and low-income families buy affordable children's health insurance.

In Texas, about 1.3 million kids have no insurance, one-tenth of the national total, state officials said.

Tyrette Hamilton, acting director of Healthy Kids Corp., told The Dallas Morning News for a story in Sunday's editions that most uninsured children live with one parent. However, about one in four live with two working parents who earn as much as $35,000 a year.

"They have no alternative, nothing available to them," she said of the families. "If they buy insurance from private companies, they can't afford the premium. In some examples they can't get it. There are no health plans designed just for children."

Deborah Sosa, a Duncanville nurse and single mother, said her employer, a surgeon, doesn't offer health insurance and she doesn't earn enough to buy health insurance on her own for her three teen-age children.

"The average for all four of us would be $260 to $300 a month," Ms. Sosa said. "I'm a middle-class, single parent trying to make things work, and I can't afford it."

Florida's Healthy Kids plan has been in effect since 1991. Parents pay as little as $5 a month and up to $50 a month premium per child, depending on their income. State and local governments subsidize premium payments for lower-income families.

In Texas, parents will pay an enrollment fee, assessed over a period of months in payments of about $3, along with a monthly premium of about $50 per child. They also will pay no more than $5 a month for a "premium stabilization account" that will loan money to families who might not be able to afford the premium in a particular month.

Texas will provide $4.6 million in start-up costs for its Healthy Kids plan. But unlike Florida, the nonprofit corporation will not be supported by the government. Instead, it will be expected to become self-sustaining with donations from private sources.

"The corporation is set up to accept gifts, grants and donations -- all kinds of things that would encourage community support," said Ms. Hamilton, former deputy commissioner of the Texas Department of Insurance. "It could be a local church that buys coverage for two children or a corporate sponsor to buy coverage for numerous children."

Healthy Kids Corp. will arrange with private insurance companies in various regions of Texas to provide care through the doctors, hospitals, laboratories and clinics on that plan, Ms. Hamilton said.