Virginia ranks 25th nationally in the percentage of children who lack health insurance according to the U.S. Census Bureau. The commonwealth has the 11th highest total number of uninsured children in the United States, estimated at 88,500. This means no well-baby or well-child checkups, no vaccines and no vision or hearing checks. There is no one checking off developmental benchmarks.
This year, for a third time, the General Assembly is considering “Cover All Kids” legislation designed to give some of these children access to coverage. The proposed legislation, Senate Bill 231, would create a new health coverage option. The eligibility process and income requirement would be the same as Virginia’s Medicaid/FAMIS program with the following: The child must live in Virginia, be uninsured, be under the age of 19, live in a family that meets the income requirements and be a U.S. citizen or lawfully residing immigrant. The income requirement is less than 205% of the federal poverty level, which is approximately $5,200 per month for a family of four.
“Cover All Kids” legislation would create a program that changes one component of the eligibility criteria to “but for their immigration status would be eligible for medical assistance services.” In other words, the child whose family meets all the criteria but who may not have established legal status would be eligible.
In 2022, a Virginia Health and Human Resources Workgroup estimated a “Cover All Kids” option could potentially cover approximately 9,000 or 10.2% of the currently uninsured children. What do we know about children who have access to comprehensive health care? Research on children covered under Medicaid has consistently shown that those with adequate health care are more likely to succeed in school, graduate from high school and attend college. They are more likely to earn higher wages and experience fewer chronic illnesses as adults. Simply put, they lead better lives.
When the “Cover All Kids” legislation was introduced in the 2022 session, it died in both chambers. Legislators from both parties expressed concern about the price tag, which was, and still is, estimated at slightly more than $19 million in the first two years, including $11.9 million in administrative costs. A significant portion of the initial cost is a robust outreach effort: materials in multiple languages, targeted campaigns on diverse media outlets, and engagement with trusted community messengers, including faith-based organizations. The bill also includes language that assures parents that information obtained by the program remains confidential and is not disclosed for any purpose not related to the program.
This is not a radical notion. In fact, Virginia is late to the party. According to the National Immigration Law Center, 12 states (Illinois, New Jersey, New York, Oregon, Connecticut, Washington State, Rhode Island, Vermont, California, Massachusetts, Maine and Utah) and Washington, D.C., currently provide Medicaid coverage for children regardless of their immigration status.
Advocates of “Cover All Kids” argue giving more children access to health care coverage will ultimately lower the cost for the state by reducing emergency room usage and unnecessary stays in the hospital due to delayed treatment. Others point out that children awaiting refugee status would be included. Consider the Afghan families who served as guides or interpreters to the U.S. military during the mission to destroy ISIS. All valid points.
However, for a nation founded on Christian values and built with the labor and intellect of immigrants and refugees, might the stronger argument be: It is the right thing to do.
Susan M. Fincke of Virginia Beach is the former executive director of Friends of the Portsmouth Juvenile Court, Inc.