Denali KidCare: A Love Story

We didn't have insurance when I was a child. That wasn't so rare in my neighborhood and in those days. Mom paid $40 for each of her children to get an annual sports physical. We drank hot tea and lemon when we had a cold, 7-Up when we had the flu. Mom told us to be careful and gave us vitamins and sunscreen. For the most part, we were just fine.

But some kids aren't. In 2009, more than 8.3 million children across the nation were uninsured, according to an Urban Institute/Kaiser Commission estimate. In Alaska, the number of uninsured kids is estimated at more than 27,000, according to the American Academy of Pediatrics. Although my family made do with home remedies and avoided major accidents, many kids aren't as lucky. Parents choose rent and food over paying for insurance. Sometimes, accidents happen. Chronic illness happens. People take out loans to pay for medical coverage and fall deeper into poverty. Even if nothing happens, people live in fear.

When I got old enough to understand what it meant not to have insurance, I was scared, too. I didn't have medical insurance until I got my first job at 22 as a reporter at a daily newspaper. Both my brother and sister went for periods in adulthood with no medical insurance. My parents, self-employed farmers not old enough for Medicare, have no insurance. They go to low-income clinics for basic care. Their children are holding their breath until they turn 65.

Thankfully, there was a reprieve in childhood for my younger sister. In 1997, the federal government implemented the Children’s Health Insurance Program (CHIP) which gave states financial support to expand health care coverage for uninsured children who are not eligible for Medicaid. In Iowa, it's called Hawk-I; my sister went on shortly after 1997 (she was 11 then), and was covered until she turned 18. In 1997, my brother and I were already too old (aged 18 and 20).

In Alaska, the program is called Denali Kid Care (DKC). States grant eligibility at different levels. In Iowa, children of families under 300% of the Federal Poverty Level (FPL) are eligible. In Alaska, it's 175% FPL, or a little over $50,400 for a family of four. 47 states in the nation provide children’s health care for families at or above 200% FPL, putting Alaska at the bottom of the heap.

In 2007, I had a chance to study this issue and to, hopefully, make a difference. Our local organizing ministry (part of the city-wide AFACT, Anchorage Faith and Action- Congregations Together) started working on the issue of DKC. Faith-based community organizations don't just pick an issue. We listen to members, through 1-1 visits, in our congregations and communities to hear what issues concern our folks. Then we work together, with public officials, for lasting change. AFACT is a group of 15 diverse congregations in Anchorage and we represent more than 10,000 people.

The issue of Denali Kid Care surfaced in 1-1 visits. I heard it from families of our neighborhood Drop-in-Center and the West Fairview Campfire site we host. AFACT leaders across Anchorage heard similar concerns, so we formed a temporary organizing committee in 2007 to focus on DKC.

Over the past five years, we have held three public meetings with public officials about DKC. After an AFACT public meeting in 2007, the legislature increased eligibility from 150% FPL to 175%. In 2010, regulations for DKC were changed to give families 12-month continuous eligibility instead of having to re-apply every six months. Even so, Alaska remained at the bottom of the national charts on children's health care, still a firm 48^th in the nation.

Yet it was exciting to work with the other AFACT congregations on this issue. More and more families were getting health care for their kids. We worked collaboratively with public officials. The energy was terrific. Our AFACT leaders worked hard. We met with almost every Anchorage-area legislator. We held public meetings. We did 1-1 visits with our families. We traveled to Juneau to meet with legislators. We even met with the governor in August of 2009, who told us that he would not stand in the way of DKC expansion. In the spring of 2010, the legislature approved one more increase to DKC that would put our wealthy state on par with other states, an increase to 200% FPL. We were thrilled for ourselves and for our families.

Then, in June 2010, with no warning, the governor vetoed the DKC expansion bill because, he said, he had just found out that the services DKC provides for pregnant woman can include abortions.

The blow was immense to our organization. We were an ecumenical group of Lutherans, Catholics, non-denominational churches and Methodists. We didn't agree on abortion but that wasn't the point. Our faith motivated all of us to care deeply for children without health care. We cared about kids who couldn't care for themselves, motivated by the One who welcomed the lost, the least and the left-out.

Though discouraged, the leaders of AFACT agreed to move tentatively forward. We did more research with legislators, Health and Human Services staff members and the governor's staff to figure how to get more kids covered in a way that the governor could support. We thought we had it: expand DKC to cover more kids in the 0-12 range. We continued our research, this time with allies across the state who might support this plan. We thought we had buy-in among legislators. Senator Bettye Davis, who had been the original sponsor of DKC expansion legislation agreed (after persuasion) to amend her bill to expand coverage for those 0-12.

In the end, though. The bill died. DKC expansion, may it rest in peace, died April 2012. Legislators on both sides of the aisle who told us they'd vote for the amended DKC expansion found other excuses and changed their minds. The committee chair never let the bill out of committee because there weren't enough votes for it to pass. Our Alaska legislative session (a two-year cycle) is now over. Will new legislation on DKC come up in the next cycle? It's not likely, given the political climate in Juneau.

We lost. Those kids who would have been covered in the expansion will have to figure another way to see a doctor. Some families will choose emergency room care for sore throats and flu viruses, not because they want to but because they have no other option.

When our national church, the Evangelical Lutheran Church in America, created a new hymn book in 2006, they put in a new section of hymns: lament. These songs weren't new, of course, nor is the notion of singing hymns of sorrow and pain. The church has done this for ages, when all manner of powers and principalities of the world triumph over peace and justice. There are times when the church and the people of God need to lament, not just for those who have left this earth but for failures we see all around us. I need to lament for Denali Kid Care.

AFACT needed to lament, too. A few weeks ago we held an all-AFACT worship service. We read passages of lament from the Exodus story. We talked about what it feels like to be in the wilderness. We talked about how God is with us there. We ended the service with praise, praise to the God who remains steadfast. With God, there is always hope.

So, good-bye, Denali Kid Care expansion. I grieve for what could have been for our families. Yet, I give thanks for this program that has tenderly cared for the youth in Alaska. I give thanks for the national SCHIP program that cared for my sister in her youth and adolescence. I wait with hope that the God of all nations will indeed, some day, make all things new.