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Safety-net programs help more children, but large numbers remain without health insurance
DALLAS (Nov. 12, 2013) – Against the sunny backdrop of improved economic growth and employment in Dallas County — and an increase in the percentage of local children who now have some form of health insurance — many troubling trends continue to cloud the horizon, according to a new report from Children’s Medical Center on the state of children’s health and well-being. Among the report’s more worrying numbers:
The 2013 report, “Beyond ABC: Assessing Children’s Health in Dallas County,” (read the full report here) is the latest in an annual series providing current and historical data about the health and quality of life for children in the region. Last year’s edition concentrated on the five northern counties adjacent to Dallas — Collin, Cooke, Denton, Fannin and Grayson — while the new edition focuses exclusively on children in Dallas County.
“Dallas County is a bellwether in the state’s largest population center and the nation’s fastest-growing metropolitan area over the past decade. What happens here has implications for the future of Texas and the nation,’’ says Christopher J. Durovich, president and chief executive officer of Children’s Medical Center.
“For three consecutive years, the proportion of Dallas County children living in poverty has remained unchanged at about 30 percent, or three in 10 children. As our economy continues to recover, many families are not sharing in that prosperity, and children are suffering the consequences,” says Durovich.
“Poverty is the common factor in substandard academic achievement, exposure to crime, domestic abuse and illness, and poor health resulting from lack of access to preventive health care. We cannot allow the cascading effect of poverty to compromise the health and well-being of such large numbers of children — the next generation of Americans and our future workforce. If we shortchange these children now, the community will pay the price for it later,” Durovich warns.
One of the more positive trends that emerged in the new report is that Dallas County now has proportionately fewer uninsured children — 13.4 percent in 2012 — compared to 25 percent in 2008 and earlier years. While this remains worse than the national average, it represents a substantial increase in the number and percentage of children who now have access to health care.
But this finding has a double edge, as much of the gain came from Medicaid enrollment, an indicator of dire financial need. More Dallas County children than ever — 292,398 — were enrolled in Medicaid in 2012, an increase of 58 percent from the pre-recession year of 2007. In the same period, enrollment in the Children’s Health Insurance Program (CHIP) grew 65 percent, now covering an additional 66,334 children. Signed into law in 1997, CHIP provides federal matching funds to states to provide coverage for children in families above the poverty level but still unable to afford private health insurance. The report points out the gains were likely a result of community efforts — primarily outreach programs funded through the Children’s Health Insurance Program Reauthorization Act (CHIPRA) — that have been successful in enrolling eligible children in Medicare and CHIP.
In spite of additional enrollment in Children’s Medicaid and CHIP, some 90,000 children in Dallas County still have no health insurance. And even with safety-net programs, questions remain about children’s access to basic health care going forward, particularly with fewer than 30 percent of Dallas County physicians, including pediatricians, accepting all new Medicaid patients.
Also, because Texas opted not to expand Medicare under the provisions of the Affordable Care Act, it remains to be seen how many working poor families fall into the confounding gap whereby they make too little income to qualify for the federal subsidy to help pay for health insurance via the federal Health Insurance Marketplace exchange — because the law assumed such families would be covered by an expanded Medicaid program.
More than 50 local community organizations participated on an advisory board for the 2013 Beyond ABC report, establishing 61 indicators included in the report under four categories — health, economic security, education and safety. Data for the report were compiled by the Institute for Urban Policy Research at the University of Texas at Dallas.
The advisory board made several recommendations related to education, including support for universal prekindergarten, dual-generation early-childhood education for parents and children in homes where English is not the first language, expanded meal programs, and school-business partnerships to help educate a skilled future workforce — along with recommendations for safe affordable housing, more foster homes and more specialty courts handling juvenile justice cases. In the area of health services, the board recommended widespread early assessment of special needs, attaining a 90 percent or better child immunization rate for preventable diseases, and establishment of more medical homes for children, which provide pediatric primary care.
Children’s Medical Center is addressing the need for medical homes through its MyChildren’s Pediatric Practices, a growing network of primary care offices in medically underserved North Texas neighborhoods. Last year, MyChildren’s provided health care for nearly 100,000 children through its 15 locations, which will grow to 16 next week with the opening of its newest office in South Dallas on Monday. MyChildren’s accepts most forms of insurance, including Medicaid, CHIP and private insurance, and each office offers immunizations, well-baby care, preventive care and treatment of minor illnesses and injuries for all children through age 18.
“Children’s Medical Center is committed to making Dallas County a healthier place for all children, and we urge the leaders of our community to join us in developing and providing new solutions to address the health, safety, economic and educational needs of our families,” said Durovich.
Founded in 1913, the not-for-profit Children’s Medical Center is the fifth-largest pediatric health care provider in the country, receiving nearly 700,000 patient visits annually with 595 licensed beds at its two full-service campuses in Dallas and Plano, and multiple specialty clinics and 16 primary care MyChildren’s locations. Children’s was the state’s first pediatric hospital to achieve Level 1 Trauma status and is the only pediatric teaching facility in North Texas, affiliated with UT Southwestern Medical Center. This year, Children’s is celebrating 100 years of making life better for children. For more information, please visit www.childrens.com.