Health Insurance for Children

The Program: In Georgia it's Called PeachCare.

It is a program for providing health insurance to children. (There is a version of it in every state, and there's also Medicaid)

Who is Eligible?

Children who live in a household that does not qualify for Medicaid, but whose household income is less than or equal to 235% of the federal poverty level. That works out to be $51,818 annually!

Cost of Service to Recipients

For children under the age of 6 years, there is absolutely no cost. For everyone else, up to the age of 18, the monthly premium ranges from $10-$70. And that price is good even if you have 23 sons named Dave living in the same household. There are no co-payments or deductibles with any of these plans.

Cost to Someone Purchasing Similar Service
 
I searched for private plans that have no co-pay as well as no deductible. The posse is still out looking. I have compiled a few quotes that I got from eHealthinsurance. The customer is a female, under the age of 6 years, living in Georgia. (This child would be included in the free category mentioned above.)

Quote 1
Plan Type: PPO
Deductible: $0 (Looking good so far)
Coinsurance: 40% (Yikes!)
Office Visit: $40 copay / $50 for a specialist
Generic Prescriptions (Real ones aren't covered): $20 copay
Monthly Premium: $224 (Oh my gravy!!!) That's $2,688 a year, even if you never have to go.
Annual Out-of-Pocket Maximum: $12,500

Quote 2
Plan Type: PPO
Monthly Premium: $32.79 (Comparable to the older kid's payment)
Coinsurance: 30% (Better than Quote 1)
Copay: $30 for the first 3 visits (Then equal to the coinsurance)
Generic Prescriptions (Real ones aren't covered): $15 or 40% coinsurance
Deductible: (Hold on to your shorts) $20,000
http://www.peachcare.org/Default.aspx

Tax Dollars Going to Program Each Year

In the year 2008, Georgia tax payers and national tax payers put forth $661,000,000 to fund PeachCare alone. At this time there were approximately 206,700 children being covered. That equals $3,197 for each child. Parents of these children have has to pay out $820 (at most, some only $120, and others, absolutely nothing). Oh, by the way, many of us are paying for our own children's health insurance and care, while also footing the bill for some children whose parents just "can't afford it".

Fraud in The Program

There are many different accepted documents for verifying eligibility for this program, and they can be found here. But, I believe that the program is only supposed to be opened to human children. Georgia Representative Sean Jerguson said that a friend of his was able to receive benefits for his quarter horse through the Peachcare program. Exactly how much verification is taking place after the forms are filled out and handed in? Another government official, Gerald Lewey, pointed out there are "parents [who are] making too much money, and even illegal immigrants being enrolled" and that the  "task is just too big for the State, and we believe that private vendors can do a better job of insuring that only qualified children are on Peachcare."

Proponents Say

If everyone had free health insurance then everyone could go to the doctor or hospital whenever they felt sick.

Opponents Say

If everyone had free health insurance then everyone could go to the doctor or hospital whenever they felt sick.
Wait, what? They agree? Well, in a way. It is true that everyone could go to the doctor when they felt sick, but if they never had to pay for it, they would go all the time...even when they just had a cold. Let's see, when a hospital gets crowded what happens? The lines get long, and the wait to see a specialist, to get an MRI, or to have surgery are as long as a season. This is the case in Canada where basically everything medical is completely covered (through the payment of taxes. On average 12% sales tax and a progressive income tax up to 29%, not to mention the additional provincial income taxes).


Would I Qualify for This Program?

I live in Georgia and I earn about $28,000 a year. I have a family of four, so that means that I would qualify for this program. By a wide margin. I do not participate. I purchase health insurance through a private company. I used to purchase health insurance through my employer, but when I left that job I found out that I could get less expensive insurance that fit my family's needs and not the needs of every other family in that group. My monthly premium dropped almost by half.

The underlying philosophy is that with no copay and no deductible, people will consume much more care than they otherwise would if they were paying for all or some of it. 


http://www.medicalnewstoday.com/articles/94249.php

http://www.georgia.gov/00/channel_title/0,2094,31446711_32076038,00.html

http://www.electsean.com/CMS/News/PEACHCARE%20OVERSIGHT%20LEGISLATION%20MOVES%20FORWARD.doc.pdf