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w w w. A R F i n i s h L i n e . o r gEvery child needs health insurance

Children do better when theyhave quality health care that givesthem the healthy start they need.ARKids worksARKids First, Arkansas’ health insurance programfor children, is an effective and popular way toprovide affordable and quality health care. More than half of allArkansas children are enrolled in public health insurance, whichincludes ARKids First and Medicaid. These programs arepopular in every corner of the state and they are supported byArkansans of all political and economic backgrounds.ARKids First offers everything a family needs to keepARKids is . . .children healthy: medical, dental, MEDICALvision, hearing and mental healthservices. It also covers prescription DENTALdrugs for children and prenatal VISIONcare for mothers. HEARINGArkansas has proven to thecountry that our state’s children’shealth care program is effective andefficient. We were one of the firststates to create a children’s healthinsurance program for low- andmiddle-income families in 1997.Since then, we’ve cut the numberof uninsured Arkansas childrenfrom 21 percent to 9 percenttoday. Now Arkansashas a rate ofuninsured childrenthat is below thenational average. MENTAL HEALTH PRESCRIPTIONS PRENATAL CARE

ARKids makeseconomic senseHealthy children are better able to learn and thrive,allowing them to grow up to better contribute to theircommunities. Many states — large and small — are workingto cover all children right now.Arkansas cannot afford to miss investing in healthy childrenif we want a healthy economy. Health insurance for childrenis a wise investment. We can support an efficient and effective program now, or pay more later for long-term treatmentfacilities, education remediation programs and a host of otherexpensive services.Arkansas cannot afford to missinvesting in healthy children ifwe want a healthy economy.

We’re almost tothe FINISH LINEArkansas has made strong progress, but there isstill work to be done. Nine percent of Arkansaschildren – 69,000 – still have no insurance. Two outof three of those children already qualify for ARKidsFirst or Medicaid but aren’t enrolled. Many of the restnearly qualify, but their families earn slightly too much. Butthey also make too little to buy private insurance, or theywork for employers who don’t offer coverage, so they areleft with few health care options.We don’t need to create a special program or agencyto get all children covered. We need to remove barriersthat have stopped families from enrolling their childrenand keeping them enrolled. They include a lack of front-lineworkers and resources to educate families, confusion aboutwhat ARKids First does and income limits that leavemany working families without coverage.We need to remove barriers that havestopped families from enrollingtheir children and keeping them enrolled.Percent of Uninsured Children in ish LineCoalitionformed11 11910 10950’97 ’98 ’99 ’00 ’01 ’02 ’03 ’04 ’05 ’06 ’07SOURCE: Census Bureau’s Current Population Survey

Let’s cross theFINISH LINE togetherThe Arkansas Finish Line Coalition has athree-part plan to cover every child in Arkansas.123Enroll children who already qualify forARKids First but aren’t signed up.Extend health insurance to 14,000 moreArkansas children by raising the family incomelimit from 200 percent of the federal povertylevel to 300 percent.Expand options for additional families whocan’t afford private insurance by creating a wayto buy coverage through ARKids First.Help us to reach these goals so that all childrenin Arkansas have affordable and quality health care.

Help us crossthe Finish LineSubscribe to our network to get newson the latest research and events. go towww.ARFinishLine.orgJoin us at the Capitol for rallies to educatethe public and lawmakers. Network members willbe updated on upcoming events and the latestdevelopments.Share your story of living with or withouthealth insurance. Send an email to storybank@aradvocates.org or call (501) 371-9678, ext. 107or visit www.ARFinishLine.org.The Finish Line Coalition isstaffed by Arkansas Advocatesfor Children and FamiliesElisabeth Wright BurakHealth PolicyDirector, AACF(501) 371-9678,ext. 119Kara WilkinsHealth OutreachCoordinator, AACF(501) 371-9678,ext. 113

COALITION MEMBERSArkansas Academy of Family PhysiciansArkansas Advocates for Children and FamiliesArkansas Association of Education AdministratorsArkansas Children’s HospitalArkansas Community Action Agencies Association, Inc.Arkansas Education AssociationArkansas Head Start AssociationArkansas Hospital AssociationArkansas Hunger Relief AllianceArkansas Interfaith AllianceArkansas Nurses AssociationAmerican Academy of Pediatrics-Arkansas ChapterBenefit Bank of ArkansasCommunity Health Centers of ArkansasEaster Seals ArkansasHarmony Health ClinicMarch of Dimes- Arkansas ChapterMental Health Council of ArkansasNatural Wonders Partnership CouncilNew Futures for Youth, Inc. . . and growing!The Arkansas Finish Line Coalition is supported by a grantfrom the David and Lucile Packard Foundation to AACFw w w. a r a d vo c a t e s . o r gUnion Station, Suite 3061400 West MarkhamLittle Rock, AR 72201(501) 371-9678614 East Emma, Suite 127Springdale, AR 72764(479) 927-9800

GOAL 1Enroll all eligible childrenArkansas can adopt several policies tohelp enroll more eligible children andkeep them enrolled in ARKids First.Expand income eligibility. Other states,including Illinois and Pennsylvania, have found that whenmore children become eligible, the majority of newchildren enrolled were already eligible before theexpansion. Increased awareness and decreasedstigma associated with expansions to moderate-incomechildren help reach these new enrollees.Create electronic enrollment and re-enrollment. The Department of Human Services recentlydeveloped an online enrollment tool for ARKids Firstcalled Access Arkansas. (www.arkansas.gov/dhs). Thesystem should be an easy-to-use application process,which allows for re-enrollment every year. Arkansasshould also consider incentives for qualified facilitators,such as health clinic staff or health-outreach workers, tore-enroll families during office visits through this electronic system.Begin administrative re-enrollment. There-enrollment process should include sending apre-completed form to families before their renewalmonth. Families would be asked to return the form(more on back)

only if their information has changed. Since Arkansas already verifies income from other state databases, DHSwould still be able to identify income changes amongfamilies if the form was not returned.Offer 12-month continuous coverage forARKids First A. Currently, children are covered fora full year – regardless of income changes during the12 months — under ARKids B. This helps to ensureincome fluctuations do not disrupt continuous coverage.This same benefit should be extended to ARKids First Aclients to avoid the cost of children moving in and outof coverage.Accelerate enrollment through immediate eligibility for likely-qualified children.Using trained partners located in schools or othercommunity-based organizations, Arkansas shouldscreen applicants and provide immediate coverage tochildren whose families appear to qualify. If families meet apredetermined threshold — where it seems clear theyare eligible — the screener would provide an ARKidsFirst card and then pass the completed application onto DHS for verification. This allows children to receivecoverage immediately and decreases the chance that afamily’s application will fall through the cracks.More options for streamlining enrollmentand retaining eligible children include: Providing all applications, renewal materials andinstructions in multiple languages. Monitoring effectiveness of enrollment and retentionpolicies.

GOALS 2 and 3Extend coverage tomore uninsured childrenHealthy kids, healthy economy: Wecan invest in the Arkansas economy while providing more children with health coverage and moreworking parents with the peace of mind quality coverage brings.Covering kids brings long-term benefits to thestate, since healthy children have the opportunity togrow into educated, productive citizens. But there isa more immediate return on the state’s investment,as well: for every 1 Arkansas spends on children’shealth insurance, the federal government provides 3, or more.According to estimates by Families USA, a national health care advocacy group, an annual stateinvestment of 8.5 million in ARKids First would return to Arkansas: 43.9 million in business activities 16.2 million in salaries and wages 436 new jobs(more on back)

We can cover more children by expanding the successful ARKids First program.ARKids First and Medicaid currently cover more than360,000 children. A modest state investment couldhelp cover the remaining uninsured children in Arkansas. To expand coverage, the Arkansas Finish LineCoalition seeks to:Extend health insurance to 12,000 more Arkansaschildren by raising the family income limit from 200percent of the federal poverty level to 300 percent.Expand options for an additional 11,000 familieswho can’t afford private insurance by creating a wayto buy affordable coverage through ARKids First.What would this expansion cost? To raise the family income limit from 200 percentof the federal poverty level to 300 percent, Arkansaswould need to spend approximately 8.5 million toaccess 28 million in federal dollars. Expanding options for families with moderate incomes would have a minimal cost to the state. Weextimate that families would spend 100 per child ,per month, to buy full ARKids First coverage. At thislevel, families could pay the full cost of ARKids Firstcoverage without a subsidy from the state.

ARKids First includes twoplans, based on family income.ARKids First A provides free care for a range ofscreenings and treatment services.ARKids First B, for families with slightly higher incomes, provides most of the same benefits and requiresa small co-payment for some services, including 10 forroutine visits and 5 for prescriptions.How do I know if my child is eligible? Eligibility is determined by income and the number of peoplein your family. If your family earns less than the incomelimits below, your child may be eligible for ARKids Firstplans A or B.ARKids First AFamily membersin householdBirth to 66 to 191 13,832 10,4002 18,620 14,000 3 23,408 17,600 4 28,196 21,200ARKids First BFamily membersin household Birth to 191 20,800 2 28,000 3 35,200 4 42,400 (more on back)

How do I apply for my child?Call 1-888-474-8275 or visit www.arkidsfirst.com.Learn about ARKids First and other DHS programs for which your family may qualify at the ACCESSArkansas Web site.Go to www.arkansas.gov/dhs and click onAccess Arkansas.Get help from the Benefit Bank of Arkansas withyour application. Sites are located in Hempstead, Izard,Mississippi, Montgomery, Phillips, Pulaski and Washingtoncounties. Call 877-375-0790 for exact locations.Visit a Department of Human Services CountyOffice. Find your county office at www.arkansas.gov/dhs.

Arkansas’ health insurance program for children, is an effective and popular way to provide affordable and quality health care. More than half of all . Arkansas Hunger Relief Alliance Arkansas Interfaith Alliance. Arkansas Nurses Association American