Vol. 15, No. 4, Spring 2002

Healthy Families: Taking the Pain out of Health Insurance

Jacquelyn Ross

The U.S. is currently spending more on health care than any other country in the world, and health care costs are still on the rise. According to Dr. Ane McDonald (Ojibwe/Cree), economist and health care industry consultant, recent shifts in the way health care is managed—such as the development of Health Management Organizations—have had an impact on the quality, delivery, and price of health care. Hospital care and drugs are particularly hard-hit by rising costs due to increasing monopolies in the industry, said McDonald. And drug costs have risen because of high research prices and the huge cost of advertising prescription medicine.

In Indian communities, medical costs are an even greater problem. Overall, we Natives have a life expectancy of about 55 years, which is 20-25 years lower than other communities. We have higher rates of heart disease, hypertension (high blood pressure), and diabetes. The complications of these conditions, and the consequences of not getting timely, consistent, or complete treatment, result in higher death rates for our communities.

The Indian Health Service (IHS) budget has not kept pace with increased costs and has always been substantially underfunded. IHS funding in California amounts to $750 per patient per year. (By comparison, the Veterans’ Administration allots $5,700 per patient per year and Medicaid program pays $3,859 per year per beneficiary.) Further compounding the problem, IHS patients have poor access to locally provided specialty care. Most of the specialty care service providers are located far from isolated communities. Some families earn too much money to be considered for low-income programs, yet are in great need of insurance.

Kevin McLemore (Cherokee) watches the changes in the health industry with keen interest. He is the new coordinator of the Healthy Families Outreach Program. Healthy Families is a plan recently introduced to the Indian community under the guidance of California Rural Indian Health Board (CRIHB). Healthy Families provides medical, dental, mental health, and vision coverage to children up to age 18. Under this program, the federal government provides two-thirds of the funding and the state provides the remaining third. You can sign your children up for Healthy Families right now. Starting in July, parents of these children can sign up as well if the family income is at or below 250% of the federal income guidelines. It is important to note that this program is designed for working families; families who make too much money to qualify for Medi-Cal benefits can be eligible for this program, and there are no premiums or co-payments for Indians in the program.

Have you had bad experiences with health insurance? Does it seem confusing? The Healthy Families enrollment procedures are straightforward. To sign up as an Indian family, some basic documentation is required. You can show either documentation of membership in a federally-recognized tribe; your Certificate of Degree of Indian Blood (CDIB) card, or a statement from your local Indian clinic on official letterhead stating that you are an Indian-certified applicant. There is a quick turnaround for enrollment. If, for some reason, you do not qualify as an Indian applicant, you can still have low service fees at the clinic.
Indian families are finding out about Healthy Families through a variety of efforts. In the Indian clinic in Bishop, for example, clinic staff is heavily involved in spreading the good news by wearing information badges and explaining the program to patients. At the casino in Redding, a community health advocate from the local Indian clinic will participate in new employee orientation. Other innovative outreach ideas will be put into place as well as an upcoming print media campaign.

Enrollment in the Healthy Families program can ease the financial pressure on your local Indian clinic as well. You can still get your medical care primarily through your local clinic, but the clinic will be able to bill Healthy Families and save on some of its contract health care funds. This will allow for the savings to be spent on other programs. You can sign your kids up for Healthy Families at your local Indian Health Clinic. Most clinics will even provide free assistance in filling out the forms and have postage-paid "red envelopes" for you to mail your application. Investigate this new option and see if it works for your family.