Federal health care program targets low-income children

Eduardo A. de Oliveira | 6/15/2010, 7:15 p.m.

Marcela Villarosa, 9, of Boston, is feeling weak these days.  Since she developed asthma last winter she needs constant medical attention. Marcela has already missed school a couple of times, and her mother admits that the $400 medication monthly cost is tough for the family’s limited budget.

But Marcela’s parents had no idea they could take advantage of the Children’s Health Insurance Reauthorization Act (CHIPRA), a federal law that extended government-run health coverage to kids of low-income households.

“I didn’t know my children had the right to have a health insurance paid for by the government,” said in Spanish Maria Villarosa, Marcela’s uninsured mother, who before signing up for CHIPRA had to make cuts in the family’s food budget to pay for the girl’s medication. “The health bills were a constant strain.”

Marcela is among 4.1 million children the Congressional Budget Office (CBO) estimates that are missing out on medical care that the government is willing to provide for them. In 2009, 29 million children were enrolled in Medicaid and seven million in CHIPRA, which is funded by the federal dollars.

Forty-four states already cover children in families with incomes at or above 200 percent of federal poverty level, like the Villarosas who make under $17,000 a year.

President Barack Obama signed the CHIPRA law last year, expanding a 1997 law that already provided government-covered health care for the poorest children. The update struck down a provision in the original bill that required states to observe a five-year grace period before covering children of legal immigrants.

However, many parents — especially foreign-born ones — are still facing barriers to enrolling their kids. Among the most common obstacles are lack of English language knowledge, immigration status and transportation difficulties.

But according to Roseanne Pawelec, a spokeswoman for the Centers for Medicare and Medicaid Services (CMS), some children are ineligible.

“The program only permits coverage of children of legal immigrants and also all children born in this country even if their parents are undocumented,” said Palwlec.

In Massachusetts, many health centers aren’t demanding that parents show proof of their kids’ legal status in the country.

“Those who think children of undocumented parents should not get access to health services need to understand we’re all human beings deserving of having fair treatment and access to a doctor,” said Adelina Vega, a case manager at the South End Community Health Center, Boston-based clinic where Latinos make up about 60 percent of all patients.

Raque Del Villar, a Dominican mother, is a migrant parent who relies solely on programs like CHIPRA to get health coverage for her three children. Del Villar has been living in the U.S. without papers for only three months but so far her kids have attended two doctors appointments.

“We need help because without this program we have nowhere to go,” said Del Villar, who says she has never being asked to produce legal papers.

But even Massachusetts, hailed by many as the model for national health care reform, has its homework to do.