Kate gets to the heart of a real problem here. Despite a variety of subsidized, government-run insurance programs, many of those who are eligible don't sign up. The question, of course, is why:
More than 6 million of the 9 million uninsured children in this country are eligible to receive health care coverage through Medicaid or the State Children's Health Insurance Program (SCHIP), but are not enrolled. The American Academy of Pediatrics (AAP), a national supporter of "Cover the Uninsured Week" (May 1-8), promotes outreach efforts and advocates for simplifying the enrollment process and other paperwork burdens so that eligible families can easily participate. In 2003, 4.1 million uninsured children were eligible for Medicaid, and 2.2 million uninsured children were SCHIP eligible, yet none of these children was enrolled.
Kate mentions saturation point theory, that at a certain point, parents are just too lazy, proud, or screwed up to enroll themselves or their kids in government programs. Maybe so, but we're nowhere near that point yet. Here's Kaiser:
Some low-income Americans who are eligible for Medicaid coverage do not participate in the program. For example, it is estimated that 62% of uninsured children are in fact eligible for Medicaid or SCHIP. Beginning in the 1990s, state efforts to improve outreach and simplify Medicaid enrollment processes resulted in significant increases in enrollment. However, over the last few years, financial stress has led many states to take actions that restrict Medicaid and SCHIP enrollment for eligible children and parents.
A variety of states consciously dissuade potential applicants in order to lower enrollment and costs. That means making the application process difficult, the offices inconvenient, the requirements confusing, and so on. So while we may one day reach a saturation point, we're not there yet. In the 90's, we sought out the eligible and succeeded, skyrocketing enrollment. Now, we have programs aimed at helping the most marginal, disconnected members of society and we largely rely on those folks to inform themselves and opt-in, sometimes even erecting barriers in their path. I'd call it counterproductive, but it's much closer to malicious.
