‘Lukewarm’ Official Support, Administration Difficulties Cause Virginia’s CHIP Program to Lag Behind Other States

In a three-part series, the Richmond Times-Dispatch profiles the Children's Medical Security Insurance Plan, Virginia's Children's Health Insurance Program, which "has struggled to reach a majority of [eligible] children." Since it began in October 1998, the program has enrolled nearly 32,000 of an estimated 63,200 eligible children. The Times-Dispatch contrasts this enrollment with that of North Carolina, which has enrolled all of its eligible 71,000 children, and Indiana, which surpassed the estimated 91,000 eligible children, enrolling 163,000 by late February. Child advocates point to "lukewarm support" from Gov. Jim Gilmore's (R) administration, a "cumbersome" enrollment process and the stigma applicants feel in being labeled "working poor." Since October 1998, the state has spent $52.8 million in federal funds; $1.74 million has gone to outreach and enrollment efforts. But last September, Virginia "forfeited" $16 million in unspent federal monies because it had "failed to meet federal enrollment projections." For their part, state officials say they have "taken adequate steps to inform eligible families about the insurance program," the Times-Dispatch reports. Beginning this month, the state is conducting a two-month "intensive marketing campaign" to encourage working families to enroll their children. Then in July, Virginia will "begin touting" a revised version of its CHIP program, to be called Family Access to Medical Insurance Security (FAMIS), which officials maintain will give families "more options" and also reduce the stigma surrounding the current program (Adams, Richmond Times-Dispatch, 5/13).

Arlington Sets Pace
In Virginia, Arlington County, in the Washington, D.C., suburbs, is the "largest locality" to have exceeded its projected enrollment in the state's CHIP program, surpassing an estimated enrollment of 1,260 children. In the second part of the series, the Times-Dispatch highlights Arlington's efforts, spearheaded by Ron Carlee, director of the county's Department of Human Services. When the state's CHIP program began, Carlee designated a group of employees to determine how the county should implement the coverage and shifted employees to solely work on the effort. The county's outreach efforts included a kickoff celebration after the state approved its CHIP program, mailings using county money and outreach workers who helped parents with applications. Carlee said, "People ask how you do it. Knowing that we were doing this for real people with real needs motivated us." Some health experts say the state could duplicate Arlington's success if the Gilmore administration provided the "leadership." Ian Hill, a senior research assistant for the Urban Institute, said, "If there was the right leadership coming from the state capital, local (community) leaders could have run with it" (Adams, Richmond Times-Dispatch, 5/14).

Indiana's Model Program
The May 14 Times-Dispatch also examines Indiana's CHIP program, known as Hoosier Healthwise, which within 14 months had exceeded the federal estimate of qualified children by 23,000. The Times-Dispatch reports that the support of Gov. Frank O'Bannon (D) prompted state officials to feel "comfortable trying new strategies" to enroll children. James Hmurovich, director of the Division of Family and Children in the state's Family and Social Services Administration, said that the administration set a "very clear policy direction" and then let the state's 92 county social services departments create plans on how to enroll eligible children by a certain date. "They went crazy with their ingenuity," Hmurovich said. Indiana officials also sought to reduce the stigma associated with receiving state-supported health insurance by calling both its Medicaid and CHIP programs Hoosier Healthwise and using one application for both programs. The state also spent $1.3 million during a six-month period to promote Hoosier Healthwise and has helped establish 520 enrollment centers around the state. Despite their successful efforts, state officials continue to "work enthusiastically" to enroll about 9,000 additional uninsured children (Adams, Richmond Times-Dispatch, 5/14).