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2010 Iowa Child and Family Household Health Survey Insurance Report Pete Damiano Sylvia Petersen Abby McGill 2010 Topics to be covered 2010 IHHS Overview Methods Insurance Coverage of Children in Iowa Hawk-I Health


  1. 2010 Iowa Child and Family Household Health Survey Insurance Report Pete Damiano Sylvia Petersen Abby McGill 2010

  2. Topics to be covered 2010 IHHS • Overview • Methods • Insurance Coverage of Children in Iowa • Hawk-I • Health Insurance and the Affordable Care Act 2010

  3. Primary purpose-2010 IHHS 1) To assess the health and well-being of children and families in Iowa 2) To explore early childhood issues in Iowa 3) To assess the health insurance coverage of children in Iowa and features of the uninsured 4) To assess the health and well-being of racial and ethnic minority children in Iowa All IHHS reports are available at: 2010 http://ppc.uiowa.edu/health/study/iowa-child-and-family- household-health-survey-ihhs

  4. 2010

  5. Health Insurance Coverage for Iowa Children Data from the 2010 Iowa Child and Family Household Health Survey Peter Damiano Ki Park Jean Willard Public Policy Center The University of Iowa July 16, 2013 2010

  6. Study Collaborators • Only statewide health survey • Joint effort of – Iowa Department of Public Health – University of Iowa Public Policy Center – Iowa Child Health Specialty Clinics – Other funding partners for 2010 • U.S. Department of Health and Human Services Maternal and Child Health Bureau (MCHB) • Blank Children ’ s Hospital • American Academy of Pediatrics – Iowa Chapter 2010 • ARRA funding through Early ACCESS

  7. Survey topics -2010 • Functional health status • Medical home-new – CYSHCN screener • Early childhood issues • Access to/need for care – Parental engagement – Insurance coverage – Child care • Prescription medications • Physical activity • Dental care • Nutrition • Behavioral/emotional • Substance use problems health • Social determinants of • Emergency room use health-new • Food insecurity-new 2010

  8. Methods-2010 IHHS  Population-based statewide household survey  Address-based sampling design -new  Mixed mode data collection  Telephone and Internet survey methods  AA/Latino oversample  Data collection by Univ. of Northern Iowa Center for Social and Behavioral Research 2010

  9. Methods-2010 IHHS  Data collection: Fall 2010, Spring 2011 • 180 questions max. – 22 minutes on average • 2386 completed surveys (80% mothers) – 1859 phone – 527 online • Data weighted to be more representative of state 2010

  10. Iowa ’ s children (census data) 2000 Census 2010 Census 827,983 820,510 Percent change: 0.01% from 2000 to 2010 Births leveled in 40,000 per year (+3.7% from 2000)  School enrollment down 6.3% from 2005  Families-decreased (-8.1%) from 2000  377,687 in 2000  347,118 in 2010 2010

  11. Health Insurance Coverage for Iowa Children • 75% covered by private insurance • 60% of uninsured eligible for public insurance 2010 • 31% of uninsured had parents with insurance

  12. Children ’ s Coverage by Race/Ethnicity 2010

  13. Rating Health Insurance Coverage for Iowa Children 2010

  14. Health Status by Health Insurance Coverage for Iowa Children 2010

  15. Unmet Need by Health Insurance Coverage for Iowa Children 2010

  16. Medical Home by Health Insurance Coverage for Iowa Children 2010 * ER visit: 22% private, 38% public or uninsured

  17. Worry about HC Costs by Health Insurance Coverage for Iowa Children 2010

  18. Parent ’ s Health Insurance Coverage 2010

  19. Dental Insurance Coverage for Iowa Children 18% of children were dentally uninsured 2010 -AA least likely, most likely to have public

  20. Conclusions • Iowa had low rate of uninsured children – Hispanic/Latino most likely – Half of Hispanic/Latino children had uninsured parents • Public insurance important – Rated better than public insurance – One in four young children in public insurance – Important safety net coverage for minority populations – Access/quality might still need improvement • Less likely to have medical home 2010

  21. ACA-related Conclusions • Many uninsured children in “ woodwork ” – Iowa just agreed to modified expansion for rest – Outreach via navigators will be important • Medical home-type coverage could expand – 2703 SPAs in place for Medicaid – Child enrollment low • Dental coverage could be improved – Coverage must be offered but not paid for on public exchanges • Covered and paid for on private exchanges 2010 • Can get just dental from CHIP in Iowa only

  22. Full and Past Reports from IHHS http://ppc.uiowa.edu/IHHS • Statewide results • Nutrition and physical activity • Early childhood • Insurance coverage report 2010

  23. Conclusions Vinny 2010

  24. hawk-i Outreach Sylvia Petersen, State hawk-i Outreach Coordinator Iowa Department of Public Health Bureau of Family Health

  25. H ealthy a nd W ell K ids in I owa

  26. What is hawk-i ? • hawk-i is Iowa’s State Children’s Health Insurance Program (SCHIP) • It is administered by the Department of Human Services (DHS) • Provides health care coverage for children ages 1- 19 whose families’ income falls between 200 - 300% FPL ▫ Premiums based on income • Plans through Wellmark or UnitedHealthcare

  27. hawk-i Dental Only Coverage • Provides dental care coverage for children • Same income limits apply ▫ Premiums based on income • Delta Dental of Iowa

  28. Uninsured Children in Iowa • Children without health insurance are four times more likely to go without needed care, such as preventive, dental, or mental health services. • Children without health insurance are less likely to have a regular primary care physician, and children without a regular physician are nine times more likely to be hospitalized for an avoidable health problem than children with a regular doctor. • Children without health insurance are also more likely to miss school than their peers who are insured.

  29. Statewide Outreach • The Department of Human Services contracts with the Iowa Department of Public Health to provide oversight to a statewide outreach program • State outreach coordinator • 22 local outreach coordinators

  30. Why Outreach? • Research has shown that people need to hear a message seven times before they will act. • The enrollment process can be confusing and overwhelming. • Many families don’t realize they qualify

  31. Outreach Statewide Outreach Grassroots Outreach • Increasing awareness • Building partnerships • Creating a single message • Application assistance • Developing Marketing • Targeted outreach specific to materials each community • Liaison to DHS • Outreach to four main groups: ▫ Schools ▫ Faith-based organizations ▫ Healthcare providers ▫ Special populations

  32. CHIPRA Outreach Grant • Centers for Medicare & Medicaid Services • Targeted outreach to teens • We have reached 330 teens through additional outreach efforts from this funding • Project ends at the end of August • HIT Week 2013 – August 11 th -17 th ▫ Awareness Week ▫ Video Contest

  33. hawk-i Enrollment in Iowa Since 2007 40,000 35,000 30,000 25,000 20,000 15,000 10,000 5,000 0 2007 2008 2009 2010 2011 2012 Iowa

  34. 33,000 34,000 35,000 36,000 33,500 34,500 35,500 36,500 37,000 37,500 January Enrollment Trends by Month February March April May June 2012 July August Iowa September October November December January February 2013 March April May

  35. Dental Only Enrollment 4,350 4,300 4,250 4,200 4,150 4,100 4,050 4,000 3,950 3,900 3,850 3,800 January February March April May June July August September October November December January February March 2012 2013 Iowa

  36. Questions? Contact: Sylvia Petersen Iowa Department of Public Health, Bureau of Family Health Lucas State Office Building 321 E 12 th St Des Moines, IA 50319 515-725-2856 sylvia.petersen@idph.iowa.gov

  37. 2010

  38. Families with Children and the ACA Abby McGill Iowa Department of Public Health Office of Health Care Transformation July 16 th

  39. What is the ACA? The Affordable Care Act  Signed into law on March 23, 2010  The ACA is aimed at increasing the affordability and rate of health insurance coverage for Americans, and reducing the overall costs of health care ACA Implementation Partners  Iowa Insurance Division (IID)  Iowa Department of Human Services (DHS)  Iowa Department of Public Health (IDPH)

  40. The need for health reform Too many people System focuses on Lack of attention lack health treatment instead to SDOH, health coverage & care of prevention disparities Inefficient U.S. healthcare Low-ranking U.S. delivery and spending is health outcomes payment system unsustainable

  41. Families with Children & the ACA  Insurers can no longer refuse to insure children with serious illnesses  Women will not have to pay more than men for the same insurance policies  Free preventative services (www.healthcare.gov/prevention)  Insurers can’t limit your care  Young adults under 26 can stay on parents plan  Health Insurance Marketplace

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