Keeping a child healthy shouldn't be this hard

Children get sick. Parents expect it and hope they never get anything more than a cold, but they want to be prepared for the worst. Part of that preparation is making sure their children have health insurance. Millions of low- and moderate-income families can't afford private insurance and are eligible for Medicaid or the State Children's Health Insurance Program . But either they are unaware of this or the application process is so complicated that it takes many months or longer for a child to be covered.

Sadly, long delays in getting health coverage are common. That's why the Children's Defense Fund is seeking this year to blend the two programs and make enrollment automatic.

Unless there's a change, more families will experience the same nightmare as the Uhr family. Richard Uhr, a retired AT & T employee in Houston, Texas, worked for a full year to get his grandson's SCHIP coverage renewed. Richard's son, Robert, Sr., contracted meningitis at six months old and is deaf and cannot speak.

His only means of communication is through a teletype machine or computer, which makes it difficult to deal with an agency. He worked long enough to qualify for Social Security disability insurance and has a disability pension. The family learned that Robert, Jr., his 11-year-old son, was eligible for half of his father's Social Security benefits and Medicaid health coverage as well. Things went well until a cost of living increase put Robert, Sr.'s income above Medicaid's eligibility limits. The family was informed that young Robert's health coverage would be transferred to SCHIP. There were no problems until his coverage came up for renewal.

The extensive six-month renewal form and supporting documents were too difficult for Robert, Sr., to manage so Richard Uhr stepped.

The renewal application was submitted. After a long wait, the Uhrs received a letter that Robert, Jr., was going to be disenrolled from SCHIP. Richard Uhr was concerned because he knew he had applied for renewal. He called to learn of the status of the renewal form and faxed a copy of the original. That was returned with a request for additional information. Over the course of a year, Richard received 18 letters requesting different -- and often conflicting -- missing information on his grandson's application. Names and case numbers were incorrect, records were lost and the family continued to be asked to submit information already had been provided.

None of Richard Uhr's attempts to communicate with SCHIP administrators yielded satisfactory results. He finally was connected with a supervisor who wasn't able to find the application in the computer system or even find Robert Uhr, Jr's account number. So Richard was instructed to go back to square one and reapply.

Richard Uhr appealed to the Children's Defense Fund office in Houston for help, and Robert, Jr.'s application for health coverage was ultimately renewed.

This is just one example of why the majority of America's nine million uninsured children are eligible but not enrolled in federally supported health insurance programs.

Richard notes that in Texas, when you register your children for school, parents' incomes are provided, and on that basis, eligible students are enrolled in the school lunch program. Inclusion in health care should be that simple. The All Healthy Children's Act (H.R.1688) would make child health coverage that easy.

Passage would guarantee health and mental health care for all children and pregnant women in America now. Children currently enrolled in Medicaid, SCHIP and other means-tested federal programs like school lunch and food stamps would be enrolled automatically. The process of getting uninsured children enrolled -- and keeping them covered -- would be streamlined.

In the interim, Richard Uhr says, "I'm concerned about the millions of other children who may not have a relative with the persistence, stamina and communication skills that I happen to have. Some just give up." Children's access to health care in America should not depend on geography. Why should a child in one state have fewer benefits than a child in another state? Why should children of different ages in the same family have different benefits? It is not the child's fault that the parents cannot afford private insurance.

Every child in the United States deserves a healthy start in life and the right to reach adulthood, regardless of where they live.

Marian Wright Edelman is president of the Children's Defense Fund and its Action Council whose Leave No Child Behind mission is to ensure every child a Healthy Start, a Head Start, a Fair Start, a Safe Start and a Moral Start in life and successful passage to adulthood with the help of caring families and communities.