Family Voices Testimony on the Family Health Care Coverage Act

Family Voices is a national grassroots network speaking on behalf of children with special healthcare needs.  We are also involved with Covering Kids at the N.J. Hospital Association and their advocacy subcommittee.  We support the proposed Family Health Care Coverage Act and believe it is essential to address the estimate of the Association for Children of New Jersey that only 1/3 of eligible children are enrolled in FamilyCare.

Many years ago, we were honored to be invited to then Gov. Whitman’s signing of FamilyCare, which included expansion to include adults.  At that time, NJ was in the forefront nationally by raising eligibility to 350% of the poverty level.  Studies indicate that families use one source of healthcare for all members.  When recent budget cuts caused loss of benefits for adult family members, the children for whom SCHIP (State Children’s Health Insurance Program) was originally intended to cover also lost out.  When adults have health coverage, their children will as well.

Of particular concern to us are underserved families (Hispanic and African American) identified at the N.J. Hospital Association statewide conference.  Results for these families indicated disparity in both being uninsured and poorer health outcomes.  Children and adults with medical issues who were uninsured fared much worse.  For example, an uninsured child born with heart disease may not be diagnosed until age 4 compared with a child who has insurance, resulting in a condition which was treatable becoming life threatening.  An uninsured adult with cancer many times remains undiagnosed until stage IV, at which point it is terminal.  Treatments for the uninsured are then more costly since the disease is not caught in the initial stages.  Most importantly, there are increased mortality rates for the uninsured.  Not only is it more cost effective, but it is the ethical thing to do.

We support the elimination of the many obstacles to enrollment identified by advocacy groups including Covering Kids, ACNJ, and our own Family to Family Health Information & Resource Center, including language barriers and the bureaucratic enrollment process as well as re-enrollment which affects retention.  A new statewide school outreach pilot program identified many families who were already eligible, yet needed to re-enroll for benefits.  The re-enrollment application was reviewed and simplified but the pilot showed more revisions were needed.  The passive re-enrollment mentioned in the Family Health Care Coverage Act will eliminate this barrier.  The pilot program also uses a simplified initial application, which appears more successful than the original form.  We support the notion of coordinating with school lunch programs statewide and coordination with non-public schools as well. 

A universal application card for various benefits will also assist families to navigate various systems (e.g. food stamps).  We also support collaboration with Rutger’s University to develop a revised, simplified form.  The new proposal of online applications and will further simplify the process and increase enrollment of parents and children.  Presumptive eligibility for families will assist them as well as the hospitals that provide charity care; uninsured families often use the emergency room as their regular source of care, again when it is more costly and the health condition has become more serious.  We strongly support the “buy-in” for families over income eligibility limits, similar to the proposed national Family Opportunity Act.

As NJ Coordinator for Family Voices, I receive approximately 1500 contacts per month.  Many parents who had no insurance for their children have had to quit their jobs and go on welfare to get Medicaid; this is especially true for children with special healthcare needs who have extensive medical issues.  The Family Health Care Coverage Act will restore lost benefits to vulnerable adults.  This in turn will also increase enrollment of eligible children if families have a single source of health care coverage.  There will also be a positive economic impact on providers, as more providers are accepting Medicaid since the introduction of Medicaid managed care, which also increases access for families.  Thank you for this opportunity to comment and support the Family Health Care Coverage Act. 


Lauren Agoratus, M.A.

NJ Coordinator-Family Voices