New York City Effort to Enroll Uninsured Children In CHIP Makes Slow Progress

New York Mayor Rudolph Giuliani (R) is stepping up his four-month-old initiative to enroll the city's estimated 325,000 uninsured poor children in Medicaid or the state's CHIP program with a new advertising campaign and collaboration with religious leaders who were asked to promote the program among their congregations, the New York Times reports. In June, Giuliani announced the effort, known as Health Stat, under which 5,000 city workers have been trained in government health care regulations, enabling them to explain available benefits. One hundred additional city workers have been hired or trained "more intensively" to enroll children and adults in public health care programs, while another 100 state workers from several community groups already are enrolling city residents. The city is utilizing a computerized mapping program to identify neighborhoods with "large pockets of uninsured residents." As part of the identification effort, forms that city residents must fill out for free school lunches, day care and school recreation activities include questions about children's health status. Furthermore, the city Housing Authority has notified many of its residents about Health Stat; the city Board of Education included information about health insurance to parents of 1.1 million students and then followed up with phone calls to 45,000 households; and the city Department of Correction currently distributes information about the program to families visiting inmates. Despite early skepticism, the effort has "impressed some health care advocates," the Times reports. Calling Health Stat a "real commitment," Donna Lawrence, executive director of the New York City office of the Children's Defense Fund, said, "There is no where else in the country where a mayor has given it a directive like this and taken it on as aggressively."

Slowly Increasing Enrollment
Despite the campaign, city workers find "it is often ... hard to persuade people to sign up" for insurance. The Times reports that it is "difficult to estimate the number of children enrolled as a result of the city's efforts," but notes that between January and October, 72,000 city children were enrolled in Medicaid or Child Health Plus, the state's CHIP program, bringing the city's total of uninsured children down to 253,000. However, Child Health Plus only enrolled 10,000 New York City children between June, when Health Stat began, and October. The reasons for relatively low enrollment range from families assuming they are ineligible for state or federal programs, fear of dealing with government agencies and reluctance to reveal income, the Times reports. Crimilda Rivera, who handed out stickers and other promotional items during a recent Health Stat outreach event, said, "There is a lot of fear in this community, especially among the immigrant families. But you have to be out there constantly in order for people to get to know you, to build trust, and then they will open up." Early next year, Health Stat will expand to enroll about 700,000 uninsured adults who might be eligible for low-cost coverage under the state's Family Health Plus program (Lipton, New York Times, 11/27).