The Children’s Health Insurance Program, covering low-income kids across the country, turns 25 in August, but Pennsylvania has had its own “CHIP” even longer – and it was used as a model for the federal program.
CHIP was launched in Pennsylvania five years earlier than the national program. CHIP allows states to cover children when parents can’t afford private health insurance.
Today, said Antoinette Kraus, executive director of the nonprofit Pennsylvania Health Access Networkabout 136,000 children in the Commonwealth are enrolled in CHIP, which is a slight decrease from previous years.
“We think that’s because right now, we’re still under a Public Health Emergency,” she said, “so a lot of kids are enrolled in Medicaid with their families and they can’t be cut off from coverage during this period. So , we expect when the public health emergency ends, a lot of kids will transition from Medicaid to CHIP.”
That’s because in Pennsylvania, CHIP can cover any uninsured child who is not eligible for the state Medical Assistance or Medicaid program. The current end date for the Public Health Emergency is Oct. 13, although there’s a chance it could be extended.
The Pennsylvania Health Access Network helps families find health services that fit their budget. Kraus said one persistent barrier they see is that parents don’t always know the income eligibility requirements for CHIP and assume they can’t afford it.
“But really,” she said, “for parents with very low incomes – if you’re making between $21,000 and $28,000, and you have a kid under five, or you’re making between $18,000 or $28,000 and your kid is between six and 18 – CHIP is free for them.”
Kraus added that Pennsylvania is seeing one of the lowest rates of uninsured residents in its history, both for adults and children. She credited a combination of the Affordable Care Act, Medicaid and CHIP. However, a report from 2019 showed that 4.6% of children in the state still were uninsured.
get more stories like this via email
Connecticut ranks among the top 10 states in offering access to mental health services for its youth population, according to the latest report from Mental Health America, but advocates said more could be done.
The Children’s Hospital Association said in 2020, early in the pandemic, there was a 24% increase in mental health emergency department visits for kids ages 5-11.
Bob Duncan, chief operating officer for Connecticut Children’s Medical Center and Health System, said strengthening Medicaid’s mental health investment is needed, and the nation needs more providers in the pediatric mental health system.
“We don’t have enough psychologists and psychiatrists to meet the demand needed,” Duncan observed. “Currently, there are 10 child psychiatrists per 100,000 kids. It is estimated that we need 47 per 100,000 kids.”
He shared his findings as part of a coalition which met this month with members of Congress and the Secretary of Health and Human Services. However, Duncan thinks the divisive political landscape could stand in the way of facing these challenges promptly and agreeing on dollar amounts for funding improvements to the system.
Duncan wants to expand telehealth services as a way to reach kids in different parts of the state. In the meantime, he added there are ways for adults to help the children in their lives.
He recommended parents develop a relationship with their pediatrician and seek out a psychologist, if necessary. And he pointed out parents’ first and most important step has been available all along: to talk with their children.
“Families have a chance to take time and spend time at home with their kids, and can see some of the things that their kids may have been struggling with that — in a typical environment, when the kids were in school — they wouldn’t ‘t have seen,” Duncan noted. “Taking time and creating an atmosphere where kids can talk to their parents, to express what they’re feeling.”
He remains hopeful the overall picture for kids’ mental health will improve over time, but he acknowledged the stigma persists, and keeps people of all ages from talking openly about mental health.
get more stories like this via email
The pandemic has had a significant impact on young kids’ mental health and due to long-standing treatment disparities, the mental and emotional recovery for kids of color may be more difficult than for their white counterparts.
HAS report from Mental Health America (MHA) found white children with depression were more likely to receive specific mental-health counseling. Students of color, meanwhile, typically either receive no counseling or “non-specialty mental health services.”
Dr. Asha Patton-Smith, a child/adolescent psychiatrist with the Mid-Atlantic Permanente Medical Group, said it is up to parents and caregivers to start the mental health conversation with their children.
“What I like is really open-ended questions,” Patton-Smith suggests. “Just saying, ‘Hey, you know, I was just noticing you seem a little more isolated than usual. Tell me what’s going on.’ The more open-ended, the more you’ll get a response.”
The Centers for Disease Control and Prevention advise building community connections as a way to combat mental-health issues. The Center also recommends schools link students to mental-health services, integrate social and emotional learning and review discipline policies to ensure equitable treatment.
The MHA report noted depression rates are highest among multiracial youths, sitting about 4% higher than the average. Patton-Smith said allowing treatment disparities to persist, and leaving mental-health issues untreated, can have long-lasting impacts.
“It increases the likelihood of other mental-health disorders developing,” Patton-Smith emphasized. “Depression, anxiety, bipolar disorder, untreated post-traumatic stress disorder. It can increase the likelihood of suicidal ideation or death by suicide.”
According to the Centers for Disease Control and Prevention, more than a third of all high school students reported persistent feelings of sadness or hopelessness in 2019, a pre-pandemic statistic which was already up 40% from 2009. Patton-Smith added Black children and young adults of color also may face entrenched social stigmas around mental health.
“In the African American community and the Latinx community, we still have a long way to go,” Patton-Smith contended. “There’s still challenges in understanding that depression, anxiety and mood issues are not character flaws, they’re not personal weaknesses.”
She added combating the stigma begins with conversations about mental health in churches and schools, where having a person of color involved in the conversation as a counselor or mental-health expert is critical.
get more stories like this via email
CORRECTION: This story has been updated to include the correct link to register for Medicaid in Virginia. (9:40 p.m. ET, Jul 11, 2022)
CORRECTION: The website where Virginians can register for Medicaid has been corrected. (8:45 p.m. MST, July 11, 2022)
New Virginia mothers now are eligible for up to a year of Medicaid support. It’s a major expansion of the programand advocates hope it will help reduce maternal mortality rates.
The new version of Virginia’s Medicaid program has been in the works for years, and was first approved by state lawmakers in 2020.
Previously, most new mothers were only able to draw Medicaid benefits for two months after the birth of their child. But Sara Cariano, senior health policy analyst for the Virginia Poverty Law Center, said many postpartum issues take more than sixty days to appear.
“This really is going to enhance the care the mom can get, and make sure that – if she does need any kind of physical help, behavioral health, even dental health – she doesn’t have interrupted care,” said Cariano. “She can continue on with the same provider she had through her pregnancy.”
According to a 2020 report by Virginia’s Department of Medical Assistance Services, more than 60% of maternal deaths among women with a chronic health issue happen after the 43 day mark. The maternal mortality rate for Black Virginia mothers is more than double the rate of their white counterparts.
Folks can register for Medicaid online at commonhelp.virginia.gov.
Cariano said folks who already are enrolled in Medicaid and become pregnant are automatically enrolled in the 12 month pregnancy support program, and new mothers who lapsed out of the sixty day version of the program, but still fall within the one-year range, can reapply for benefits.
She said Enroll Virginia, a coalition of community organizations, can help folks navigate the process.
“If someone has applied and is having an issue with an application, we also do a lot of case help,” said Cariano. “We do a lot of helping people navigate what can be a little bit of a complicated process for enrolling.”
So long as they meet income restrictions, all legally residing non-citizens in Virginia also are eligible for the program. Cariano said all mothers, regardless of immigration status, are eligible for coverage during the pregnancy and for up to sixty days after the birth of their child.
get more stories like this via email
.
