Child/Adolescent Health

Aggressive Medicaid and SCHIP outreach programs are needed to enroll Latino children

Despite State Medicaid health insurance programs for the poor and the State Children's Health Insurance Program (SCHIP) enacted in 1997, 8.5 million U.S. children remain uninsured. The situation is worst for Latino children, with 24 percent (3 million) of them uninsured. Even in Massachusetts, a State where all low-income children are eligible for health insurance, current SCHIP and Medicaid outreach and enrollment efforts are not reaching many uninsured Latino children, according to a study supported in part by the Agency for Healthcare Research and Quality (HS11305).

Latino parents need better information about the programs, eligibility, and the application process, as well as a more efficient, user-friendly system, notes Glenn Flores, M.D. Dr. Flores and colleagues conducted bilingual focus groups with 30 parents of uninsured Latino children from Boston communities with the highest proportion of uninsured Latino children. Two-thirds of the parents never graduated high school, only one-third were U.S. citizens, and their average annual income was $9,120.

Parents reported 52 barriers to insuring their children. Major obstacles included lack of knowledge about the application process and eligibility (especially misconceptions about work, welfare, and immigration), language barriers, hassles with paperwork, family mobility, misinformation from insurance representatives (being told insurance is too expensive and the parent must work to qualify), and system problems (including lost applications, discrimination, and excessive waits). The Massachusetts Medicaid Program requires that the child must be a U.S. citizen, green card holder, refugee, or asylee, and family income must be less than $35,920. However, receipt of welfare assistance, parental employment, and the child being in school are not an issue. Similarly, for the Children's Medical Security Program, family income had to be less than $35,920, but no other restrictions applied, such as U.S. citizenship for the child, parental employment, or welfare assistance.

See "How Medicaid and the State Children's Health Insurance Program can do a better job of insuring uninsured children: The perspectives of parents of uninsured Latino children," by Dr. Flores, Milagros Abreu, M.D., Vanessa Brown, B.A., and Sandra C. Tomany-Korman M.S., in the November 2005 Ambulatory Pediatrics 5(6), pp. 332-340.

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