AJC Article on Peachcare FYI

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I thought I posted this last night...

The face of PeachCareGeorgia's insurance for kids helps families who get by paycheck to paycheck — or don't. And for some, the benefits are not free, either.By BILL HENDRICKThe Atlanta Journal-ConstitutionPublished on: 04/08/07

Tunnel Hill — Happy and comfortable in their neat wood-frame home in a well-kept, modest subdivision, Connie and Post pride themselves on being solidly middle class folks who "thank God every day" for their salvation — and PeachCare for their solvency.

"Without it, we'd be broke," says Post, 38, welcoming visitors into his home.

Ivansco/Staff

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and Connie Post and children (from left) Jayden, Cadence and Colton are among the Georgia families who benefit from PeachCare.

Ivansco/Staff

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Post shows his PeachCare payment book. The insurance program for children isn't an entitlement; depending on the kids' age, parents pay premiums for their children signed up in the state program. Legislators are considering tightening PeachCare.

Two of their three young children are screaming playfully behind him. Post's wife, Connie, 36, is just inside, patiently trying to calm them down.

Financially, the Posts — like many families with kids at their income level — are having a tough time making ends meet.

Until recently, they were making about $48,000 a year. But, in February, Post left a job making $42,000 as pastor of Friendship Baptist Church to become a freelance minister. He supplements his unpredictable income by painting houses and doing odd jobs.

Connie, who has a degree in English, took a job making about $25,000 a year at Casey and Son Horseshoeing School in nearby LaFayette. Now, their take-home pay averages about $850 a week.

"Our income sounds pretty good until you consider all our bills," Connie says. "Especially up here in carpet country, anything over $40,000 is pretty good money. But it's paycheck to paycheck."

Their 1997 teal Ford Winstar is paid off. But they pay $327 monthly for the 2004 red Nissan Frontier pickup beside the van in the driveway. And $750 a month for their mortgage, $250 for high-deductible health insurance for "mom and dad only," about $360 a month for gasoline, $116 for auto insurance, $400 for food, $50 for cellphones, $80 for life insurance, $200 for electricity, $15 for water, $65 for telephone service, $120 for credit cards and $150 for clothes and "odds and ends." That adds up to $2,883 a month.

"That doesn't leave much," Connie smiles. "And that's why PeachCare is such a blessing. We just couldn't do without it."

It's doubtful PeachCare will go away, but the program may become less generous. A bill that passed the state House recently would require families to be poorer, reducing eligibility from 235 percent of the federal poverty level to 200 percent. The bill would also make PeachCare families pay for now-free dental and vision coverage.

Federal funding for the State Children's Health Insurance Program, of which PeachCare is part, has been held up as Congress waits to reauthorize the 10-year-old effort. In the meantime, the state Legislature has been wrestling with how to keep the struggling program afloat for the rest of the year — and into the future.

Not entitlement program

Connie's health insurance deductible is $5,000, "which means that much comes out of my pocket before insurance pays anything," she said. "'s deductible is $1,500. We're just barely holding on."

PeachCare is not an entitlement program like Medicaid. It's part of a federal-state effort to provide insurance to children of low-income working families. The families pay premiums for children 6 and older. Those who can't pay get dropped from the rolls, which, at last count, stand at around 308,000 children.

"A lot of people think it's just a handout, but it's not," says Post. "It saves a lot of families.

The Posts moved to this tiny North Georgia town from Lynchburg, Va., four years ago, when their son Colton was 2. In Virginia, they were covered by a Liberty University family plan. When they moved to Georgia and shopped around, "we saw we couldn't afford a family policy." Then they heard about PeachCare and enrolled Colton.

Since then, the boy's medical bills have been covered. And when sister Cadence, 4, came along, PeachCare covered her, too. And then Jayden, 2. And now, Connie says, another child is on the way.

The Posts just started paying for Colton, $24 a month. His two sisters are on the same policy at no cost until they turn 6.

And that's critical, because Cadence is autistic, and needs two $135 therapy sessions a week, paid in full by PeachCare. When Jayden gets sick, it pays her bills, too. And for the past six months, PeachCare also paid for weekly $135 therapy sessions for Colton, who has "sensory problems." His mother says he's shown such improvement that he no longer needs the therapy.

Without PeachCare, "it'd cost us more than $500 just for the kids," Connie says. "We don't have it, so you can imagine how grateful we are for PeachCare. Cadence wouldn't have a chance at a normal life," says Connie. "When she's 50, we want her to be able to be at least semi-self-sufficient. If they take away PeachCare, she'll have no chance."

Urging responsibility

The wrangling about PeachCare has made PeachCare families "extremely anxious," says Connie. "We just hope they don't take away the therapy benefits."

The House bill, sponsored by Speaker Glenn (R-Hiram), wouldn't affect kids already on PeachCare. But says that the time has come for parents to take more responsibility, in part through wiser family planning.

"It is the obligation of all of us to take care of those that cannot take care of themselves," he said, adding, however, that PeachCare is too generous and needs to be "reined in as much as possible."

"It was never intended to be an entitlement program, but it's becoming one," he said. "People are rapidly trying to make insuring children as if it were a constitutional right. It is not. The responsibility to take care of children is first with moms and dads. Mamas and daddies are responsible."

Families, he said, ought to decide "how many children do we have, can we afford to take care of any more, and that's what responsible people should be doing. It's expensive to have children."

Even if the threshold is lowered, as 's bill calls for, families like the Posts would still be eligible.

"But our income is going the other way," Post laughs.

Right now, his income depends on honoraria or passing the plate when he gets hired by a local church or group to talk about his vision of heaven. Sometimes, he gets $100 or so, but "it depends on their offering," he says.

expects his ministry business to pick up. Connie has taken on some freelance graphics-designer jobs, and he's doing some house painting and yard work in the area.

Though some view PeachCare as an entitlement program, it's not because "only families below a certain income are eligible," says Custer, director of the Center for Health Services Research at Georgia State University. "Really, it's more like a tax credit for college tuition that decreases as family income increases."

He says PeachCare should "be thought of as a bridge for working people that moves them into private health insurance" when their incomes rise sufficiently, and in the meantime "provides care to children who would otherwise be uninsured. If they were uninsured they would still get sick, and get even sicker because of limited access to care.''

What many lawmakers don't seem to recognize, Custer says, is that in the long run, PeachCare reduces health care costs and saves taxpayer dollars.

"I just shudder to think where we'd be without PeachCare," Connie Post says. "We work hard, pay our bills. But we're middle class, and if it weren't for PeachCare, we couldn't afford to have health insurance for the children. I just shudder to think."