More than 27,000 of Hawaii’s children and youth lack health
coverage despite the July 2000 expansion of Medicaid’s QUEST
and Fee-for-Service programs, according to the University of Hawaii
Social Science Research Institute (SSRI). Of these, as many as 14,000
are eligible for government-sponsored programs but are not enrolled.
SSRI reported these numbers in 2003 based on a 7-year average (1996 – 2002)
of the Current Population Survey conducted by the U.S. Census Bureau.
is believed that if all eligible children were enrolled, more than
2,500 could potentially be covered if the family income requirements
were increased from 200 ($42,336 for a family of four in 2003)
to 300 percent ($63,504 for family of four in 2003) of the Federal
Poverty thresholds differ by the size and makeup of a household.
While the Hawaii Health Survey and the U.S. Census Bureau’s
Current Population Survey affirm that 2,500 are in this ‘gap
group,’ the SSRI research team believes that this is an undercount.
the family income limits were increased to just 200 percent of
the FPL, Med-QUEST’s data indicated there were only 4,000
uninsured kids in this group,” said Barbara Luksch of Hawai‘i
Covering Kids, a statewide effort to find and enroll all eligible
and youth. “However, as of July 2003 more than 10,000 children
and youth have been enrolled in this expansion group.”
health care prevents unnecessary and expensive emergency room
as well as helps children to be healthier and less likely to miss
school and other activities.
Common untreated ailments such as
throats, ear aches, and asthma can interfere with school attendance
and result in learning problems.
Also, health insurance is required
to participate in field trips, which are vital to children’s
learning. Accident insurance can be purchased for field trips
a cost of $4 per day or $16 for the school year, but even this
may be a burden on low-income families with several children.
such insurance only covers accidents on school outings, not regular
preventive care or ordinary illness.
The following statistics were reported by Cover the Uninsured
Week, a national initiative of The Robert Wood Johnson
- Nearly three quarters of families with uninsured children do
not have access to an employer-provided health coverage plan.
- Eight of 10 uninsured children live in households where at least
one of the adults is working.
- Most children are covered by an employer-based plan or privately
purchased health plan, but Medicaid covered nearly one in four.
- One in five parents of uninsured children has kept or would
keep their children from participating in extracurricular sports
because they fear that their children might get injured.
- In 2001, children 12-17 years of age were more likely to be
uninsured than those younger than 12.
& Medicaid Fee-for-Service Programs
84,100 in Children & Youth
ENROLLMENT AS OF FEBRUARY 2003
of Both Programs
|Regular Medical Check-ups
||Vision & Dental Care
|Mental Health Services
QUEST. For children and youth who
are not in a pubic institution nor certified blind or
Medicaid Fee-For-Service. Pays healthcare
providers directly for their services and participants
must be certified by the state as blind or disabled.
State’s “Expansion” Programs
11,450 Kids Enrolled
ENROLLMENT AS OF FEBRUARY 2003
State Children’s Health Insurance Program
(SCHIP). With enhanced federal matching rates
in July 2000, this program allowed states to expand
their Medicaid programs (QUEST & Medicaid Fee-for-Service)
to include kids in families with incomes up to 200 percent
of the FPL. This has meant health coverage for 9,474
children in 2003.
Immigrant Children’s Program.
This program allows all immigrant children and youth
to receive public health coverage. Compact states include
the Marshall Islands, Federated States of Micronesia
and Republic of Palau. This has meant coverage for 1,981
Pacific Island children from these locations.
Hawaii’s Only Private Insurance Option
HMSA’S CHILDREN’S PLAN
This plan is available to Hawaii’s children from
1 month to 18 years old. At a monthly fee of $58.50
in 2003, it provides limited services, such as preventive
care, immunizations, and doctor visits.
Uninsured Project has formed a committee of advocates, health care
and health coverage experts, and state officials to develop and
analyze potential solutions for increasing coverage for children,
with an emphasis on those in families with incomes from 200 to 300
percent of the FPL.