In 2006, Congress enacted a law that required people to submit a certified birth certificate to qualify for Medicaid, the government health insurance program for low-income people.
The law was intended to prevent undocumented immigrants from obtaining health care, but it had unintended consequences for U.S. citizens, says Hugh “Trey” Daly III, J.D., a legal advocate for low-income people in Ohio. Enrollment in Medicaid began to drop because low-income people weren’t able to take time off from work to stand in line and pay the fees for certified copies of birth certificates, he says.
Onerous paper requirements like these, Daly says, stand in the way of getting children and others who are eligible for Medicaid the health coverage they need to be and stay healthy.
“It shouldn’t take a lawyer to get on Medicaid, but it often does,” Daly says. “Most people are denied coverage not because they are ineligible, but because they lack some kind of documentation or verification.”
A senior attorney at the Legal Aid Society of Greater Cincinnati and a Robert Wood Johnson Foundation (RWJF) Community Health Leader, Daly has devoted his career to helping low-income people overcome barriers to health care coverage.
His latest effort is a two-year campaign to enroll 1,800 eligible children in Medicaid, which would represent about 10 percent of all uninsured children in southwestern Ohio. The effort—funded by a portion of the 2009 reauthorization of the Children’s Health Insurance Program—is targeted at teenagers, Latinos, native-born children whose parents are undocumented immigrants and children from rural areas.
Daly and his colleagues at Legal Aid launched the Medicaid enrollment campaign at a March 15 press conference on the steps of Walnut Hills High School in Cincinnati. The event was a big success, he says, thanks in part to a series of events that sparked the interest of local media.
One week before the press conference, Ohio Gov. Ted Strickland announced that he would attempt to simplify and ease the process by which children and families can sign up for Medicaid. He also became the first governor in the country to accept a challenge by Kathleen Sebelius, Secretary of the U.S. Department of Health and Human Services, to attempt to enroll all uninsured children in Medicaid over the next five years.
On top of that, Ohio Rep. Steve Driehaus—who was then wavering in his support for the health reform law that passed later that month—spoke at the event. “He was the hot item,” Daly recalls.
Daly Rolls Out Series of Medicaid Enrollment Activities
Daly followed up with Medicaid enrollment activities including a televised phone-a-thon, volunteer events at area supermarkets, the placement of bilingual staff at organizations that serve the Latino community, and the creation of an insurance enrollment page on Facebook. He’s also planning back-to-school initiatives targeted at teens, who comprise the bulk of eligible—but unenrolled—children.
Daly is optimistic that he will meet his target when the campaign concludes in 2012 and, more broadly, that more people of all ages will get the coverage for which they are qualified.
Thanks to the reauthorization of the Children’s Health Insurance Program, states are now allowed to exchange data with the Social Security Administration, so certified birth certificates are no longer necessary. And the health reform law should make it easier for low-income families to meet requirements to apply and qualify for Medicaid, he says.
Daly was named an RWJF Community Health Leader in 2009 for his efforts to obtain health care for low-income and sick people in southwest Ohio. He is using the award, which carries a $125,000 prize, to advocate for policy changes to the Medicaid enrollment process—work that complements the grassroots Medicaid enrollment campaign that is now underway.
Among the highlights of his career is a project that made it possible for Medicaid applicants in his area to submit paperwork on evenings or weekends at their local libraries, where parking is free. He has also published a health care guide to help the uninsured figure out how to obtain care. And he helped found two coalitions that work to expand access to health care for low-income people.
Daly was inspired to pursue legal aid—instead of a more lucrative career in private practice—by his father, a hospital social worker for more than four decades. Daly’s father passed away in June, after which he heard from numerous colleagues who also worked with his father. “It feels like I’m at the other end of a bridge,” he says.