Kansas health officials Wednesday pushed for support of Gov. Kathleen Sebelius' proposal to expand health care coverage for children, but were asked why thousands of children eligible for current programs weren't in it.
"Before we expand entitlements, we should increase enrollment in existing programs," said Sen. Jim Barnett, R-Emporia. "That would be much cheaper and more efficient."
But health policymakers said enrollment problems have always existed in programs for low-income Kansans and that expanding coverage would probably help get some of those children in the system.
"In terms of policies, this is our No. 1 priority," said Marcia Nielsen, executive director of the Kansas Health Policy Authority.
The recommendation by Sebelius was trotted out before the Senate Financial Institutions and Insurance Committee for an informational hearing.
Sebelius has proposed spending $4 million in state funds to increase the income eligibility limits for people to have their children who are up to 5 years old covered under HealthWave, which is designed to provide low-cost insurance to low-income Kansans.
Under the plan, families earning up to three times the federal poverty limit would pay a sliding scale of premiums for health care coverage for their children.
Three times the federal poverty limit would be up to $49,000 per year for a family of three. Depending on income, premiums would range from $20 per month per family to $150 per month per child.
Officials said they expected the plan to serve 2,000 children in the first year of operation.
But that is below the estimated 15,000 children younger than 5 who are uninsured. Of that number, 10,000 are believed to be eligible for HealthWave or Medicaid, which serves even lower-income Kansans.
Sen. Karin Brownlee, R-Olathe, asked if it wouldn't make more sense to make sure those who are currently eligible get into the programs.
Andrew Allison, acting Medicaid director, and Nielsen said they planned to work in both areas: expanding eligibility and getting people enrolled through increased marketing and making the process easier.
Allison said there are many reasons why some people do not enroll their children into the health care systems.
Many are swamped with other duties and problems, while others don't want government assistance, he said.
Meanwhile, advocates for children and the uninsured urged passage of the plan.
Cindy D'Ercole, of Kansas Action for Children, said expanding coverage would help children succeed and save money in the long run.
"Children with a medical home are less likely to rely on the emergency room and other costly forms of care," she said.
Karla Finnell, executive director of the Kansas Association for the Medically Underserved, said from 2000 to 2006, wages increased 16 percent, but health insurance premiums increased 78 percent.
"It is simply becoming more and more difficult to afford health care insurance that ensures access to care," she said.