Will the Real Numbers
Please Stand Up
The US Census Bureau
recently published data on children’s uninsurance rates.
The Census Bureau’s Current Population Survey (CPS)
conducted in March of every year, showed that West Virginia
has 36,000 children without health insurance. The estimate
was based on an average of 3 years of survey data.
The West Virginia
University Institute for Health Policy and Research
conducted state surveys in 2001 and 2003.
The 2001 Survey showed that 28,371 (6.6%) of children were
uninsured at a point in time; the 2003 survey showed that
30,884 (7.6%) children were uninsured at a point in time.
Another way to look at health coverage for children is
to estimate the number that go without coverage for a full
year. In that instance, the West Virginia Survey showed in
2001 that 18,399 (4.3%) of children were without coverage
for a full year; the 2003 survey showed that 15,036 (3.7%)
children were without coverage for a full year.
Reasons for Difference in Numbers:
The key reasons for the variation
between state estimates and CPS estimates of rates of
uninsured are differences in:
Sample selection and size:
The sample size for the WVU survey in 2003 was 1,600
(including 460 children); the CPS sample is about 600 or
1,800 for three years.
Survey administration:
CPS interviews families in person as well as by phone. The
WVU survey was exclusively a telephone survey , but takes
people without a phone into calculation.
Definition of the uninsured:
The CPS defines a person as uninsured only if he or she
lacked insurance for the entire year. The WVU survey
defines a person as uninsured (1) at a point in time if he
or she is uninsured at the time of the survey, (2)
uninsured for the entire year.
Survey question design:
The CPS may tend to underestimate public program coverage.
Respondents on Medicaid may not know the name of the program
(they may know they have a medical card but not know that it
is an insurance card called Medicaid or CHIP); The growth in
uniquely labeled Medicaid managed care programs may be an
additional source of confusion, causing respondents to fail
to report Medicaid coverage.
Policy Implications
State policy makers and analysts should understand the
reasons why the state and CPS estimates differ as well as
the appropriate uses of each type of estimate. The CPS
estimates are consistent and available on an annual basis.
They are more appropriate for examining aggregate data
trends over time and for cross-state comparisons.
Estimates from state surveys are more
useful for sub-state geographic and population estimates.
State surveys can help define more specifically which
populations (children) are uninsured within the state to
facilitate the design and evaluation of state-specific
programs. They can also be used to detect year-to-year
changes in the uninsurance rate if the sample size is large
enough.
In West Virginia, we believe that the
CHIP and Medicaid programs are reaching the target
population and that the WVU Survey estimates are a realistic
reflection of the rate of insurance among children.
WVHKFC Partners with WV Immunization Network (WIN)
The West Virginia Immunization Network
(WIN) is a coalition of volunteers working together to
improve the health of all West Virginians through increased
awareness of the importance of immunization. It is
made up of business people, health care organizations,
government agencies, and volunteers from the community, who
work cooperatively to prevent disease through increased
immunization rates across the lifespan of West Virginians.
WIN’s goals include:
-Promoting current national immunization recommendations
-Promoting accurate assessment or statewide immunization
levels
-Promoting accurate surveillance of vaccine-preventable
disease
-Supporting statewide public and professional education
-Facilitating and supporting partnership formation among
community groups, health care providers, businesses and
other agencies throughout West Virginia
-Advocating legislative and organizational policy issues
relating to immunization
Together we can WIN the battle against vaccine-preventable
diseases.
For more information or to become a member visit the
WIN website at
www.immunizenow.org or contact:
Sherri McCowin
Center for Rural Health Development
500 Westmoreland Office Center, Suite 201A
Dunbar, WV 25064
304-766-1591
sherri.mccowin@wvruralhealth.org
Mark Your Calendar for Children's Day at the Legislature
2005
Once again, child
and family advocates from across the state will join at the
State Capitol for Children’s Day at the Legislature. This
annual event is set for February 16, 2020.
A Children’s Policy Forum will also be held preceding
Children’s Day on February 15, 2020.
These events are still in the planning stages. We will
have more complete information in the next issue, but mark
your calendar now for these important events.
What We Learned from the Process Improvement Collaborative
Reminding families to re-enroll at the end of
the 12-month enrollment period.
West Virginia was one of thirteen states
working with the Southern Institute on Children and Families
and the Robert Wood Johnson Foundation in studying ways to
improve eligibility and enrollment for CHIP and Medicaid
children. State CHIP officials were concerned that 45
percent of CHIP children lost coverage at the end of the
12-month enrollment period. Starting in December 2004, we
began calling CHIP families close to the end of the
enrollment period.
After eight months of data, we found that 27 percent of
all children did not re-enroll because they (1) were too old
for the program, (2) their families got jobs with higher pay
and/or health care coverage, (3) family income declined and
children were enrolled in Medicaid, (4) families were
leaving the state. We are still concerned about the 18
percent who lose coverage because they do not re-enroll in a
timely manner.
Community health programs and outreach workers need to
remind families that it is important to maintain continuous
coverage and re-enroll annually.
Coalition Holds
Gubernatorial Forums
The West Virginia Healthy Kids and
Families Coalition together with its partner organizations
held a gubernatorial forum in September with Gayle Manchin,
wife of Democratic candidate for governor Joe Manchin (now
Governor-elect). A similar forum was held in October with
Monty Warner, Republican candidate for governor.
Both candidates or their representatives answered the
same set of questions. The goal of the forum was to promote
understanding and engage in dialogue on children’s health
issues in non-partisan way.
Educating New Lawmakers
The Healthy Kids
and Families Coalition is planning a Children’s Health
Institute in early February for new legislators to help them
understand CHIP and Medicaid.
WVCHIP
Enrollment Continues to Increase
CHIP enrollment has stabilized around 24,000 children per
month – this number represents an increase over previous
years. About 166,000 children are enrolled in Medicaid in
any given month. Because children go in and out of
coverage, numbers enrolled in any one month will be smaller
than the total unduplicated count of children enrolled in a
one year’s time. In federal fiscal year 2003, 240,000
children had been enrolled in Medicaid or CHIP during the
twelve months of the fiscal year (October 1, 2020 –
September 31, 2020). We expect to see similar numbers or
more in federal fiscal year 2004, which ended on September
31, 2004.
Medicaid and Women: What's at Stake?
One in 10 women in America are covered by Medicaid. These 16
million women make up nearly three quarters of the adult
Medicaid population, yet Medicaid is not typically thought
of as a women's health program.
On November 10th, representatives from leading health
care and women's organizations attended "Medicaid and Women:
What's at Stake?" a forum hosted by the Kaiser Family
Foundation, the Allan Guttmacher Institute, and the National
Women's Law Center. The forum featured an overview of how
Medicaid works for women, including new data about the
program and the women it serves, as well as an overview of
key issues in Medicaid and reproductive health care, and a
discussion of what may lie ahead for Medicaid in light of
the election and some of the debates facing state and
federal policymakers.
Speaker presentations and the following new materials -
"Women's Health Insurance" fact sheet, "Health Insurance
Coverage of Women" fact sheet, and "Medicaid's Role for
Women" issue brief, are available
here. An archived webcast of the event will be
available on this page after 5 p.m. ET, Wednesday, November
10.
Please contact Usha Ranji for additional information at
(650) 854-9400 ext. 257 or
uranji@kff.org . For media inquiries, please contact Rob
Graham at (650) 854-9400 ext. 237 or
rgraham@kff.org .
Who
Should Get a Flu Shot and How to Prevent Getting the Flu
Because there is not enough flu vaccine for everyone who may
want to get it this year, the Centers for Disease Control
and Prevention has said that certain people should have
priority getting a flu shot this season. The flu shot should
be given to protect people who are most likely to have
serious health problems if they get the flu. All health
departments and physician’s offices should be using the same
guidelines when deciding who should get the vaccine.
Who should get a flu shot?
· Children
ages 6 months to 23 months.
· People
who are 65 years of age and older.
· People 2
years old or older who have an underlying, long-term illness
(heart or lung disease, metabolic disease [like diabetes],
kidney disease, a blood disorder, or a weakened immune
system (including people with HIV/AIDS)).
· Women
who will be pregnant this season.
· People
who live in nursing homes or other chronic-care places.
· People
who are 6 months to 18 years of age, and take aspirin daily.
·
Health-care workers who take care of patients.
· People
who have or take care of a baby under 6 months old. (Do not
give a flu shot to babies under 6 months.)
If you are someone who should get a flu
shot and your clinic or doctor does not have vaccine,
contact the health department or ask your doctor or someone
at your clinic where you can get a flu shot. Healthy people
aged 2 to 64 years should wait to get a flu shot or skip
getting a shot this season so others at risk may receive
one.
What can we all do to help stop the spread of
flu?
· Cover
your nose and mouth with a tissue when you cough or sneeze –
throw the tissue away after you use it.
· Wash
your hands often with soap and water, especially after you
cough or sneeze. If you are not near water, use an
alcohol-based hand cleaner.
· Stay
away as much as you can from people who are sick.
· If you
get the flu, stay home from work or school. If you are sick,
do not go near other people so that you don’t make them sick
too.
· Try not
to touch your eyes, nose, or mouth. Germs often spread this
way.
times.