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For more information about the hawk-i insurance program, call toll-free (800) 257-8563 or visit the Web site

Release: March 29, 2001

NOTE TO EDITORS: The report mentioned in this release, "HAWK-I: Impact on Access and Health Status," is available at: Pete Damiano, the report's primary author, can be reached at (319) 335-6813.

UI study: HAWK-I insurance program increases access to health care for Iowa children

IOWA CITY, Iowa -- Children enrolled in the Healthy and Well Kids in Iowa (HAWK-I) health insurance program have better access to health services than before enrolling in the program, according to a report by the University of Iowa Public Policy Center.

Moreover, many parents whose children are enrolled in the program reported that their children's health has improved, children miss less school and the insurance coverage helps reduce feelings of stress for the entire family.

The results are the first in an ongoing evaluation of the HAWK-I program, which was launched by Iowa's State Children's Health Insurance Program in early 1999. The HAWK-I program provides health insurance coverage for uninsured children whose families do not qualify for Medicaid coverage yet earn less than twice the poverty level. For example, families of four with earned incomes up to approximately $42,000 could qualify for the program. To date, nearly 7,000 families have enrolled in the HAWK-I program, which is administered by the Iowa Department of Human Services.

The report, "HAWK-I: Impact on Access and Health Status," is also among the first published evaluations of any State Children's Health Insurance Program, the state/federal program that nationwide provides health insurance to millions of low-income children, said Pete Damiano, D.D.S., the report's primary author and director of the Health Policy Research Program at the UI Public Policy Center. Damiano also is an associate professor in the UI College of Dentistry.

The evaluation was based on a comparison of Iowa parents' responses to a survey given when their children were initially enrolled in the insurance program (January to November 1999) and survey responses one year after each family's enrollment. The report can be accessed online at

Damiano said the survey questions focused on parents' perceived ability to use the HAWK-I program to receive medical, dental, vision and behavioral health care services and prescription drugsfor their children. The survey also measured parents' assessment of their children's health status.

"At the baseline survey, most parents whose child had a barrier to health access reported that the barrier was related to cost," Damiano said. "A year after enrollment, we found parents reporting similar needs for medical care, specialty care and dental care. Parents, however, were less likely to say their child had been stopped or delayed from receiving care. Parents also were more likely to report having regular sources of medical and dental care for their child."

The investigators also found that 95 percent of families reported reduction of stress after receiving health insurance coverage. More than three of every four families reported stress had been reduced "a lot."

One finding that surprised investigators was that after being in the HAWK-I program for one year, children were reported by their parents to be in significantly better health than one year earlier.

"We didn't expect for the health insurance coverage alone to make that much of an impact," Damiano said.

"Parents' perception of their child's health is one way of looking at the health of children," he added. "While it doesn't necessarily mean the children are healthier, the parents in general reported that their children's health was the same or better than before enrollment in the HAWK-I program."

For children who had a chronic health condition, almost one-third of the parents said the condition was identified while the children were receiving care through HAWK-I. In addition, children were significantly less likely to have any sick days in the four weeks prior to their parents' completing the follow-up survey than for a similar four-week period prior to joining HAWK-I. Children who did have sick days after enrollment in HAWK-I reported fewer sick days on average over the same four-week period.

Parents also reported that with the new health care coverage, they were less likely to limit the activities of their children.

"We had heard that parents may prohibit activities such as contact sports because they are afraid of what might happen if an uninsured child gets hurt," Damiano said. "This finding indicates that the HAWK-I program makes parents more comfortable letting their kids be active."

Through the HAWK-I program, families with incomes from 134 to 150 percent of the federal poverty level pay no premiums or copayments. Families with incomes from 151 to 200 percent of the federal poverty level pay a premium of $10 per child monthly with a maximum of $20 per family per month. Families in this category also pay $25 for certain emergency room services.

Nearly 25 percent of the funding for the HAWK-I program comes from the state of Iowa while the other 75 percent draws on federal funds.

The UI Public Policy Center will continue to evaluate the HAWK-I program as new families enroll and others continue with their health coverage. The current HAWK-I study was supported by the Iowa Department of Human Services. In addition to Damiano, the UI Public Policy Center research team included Jean Willard, research assistant, and Elizabeth Momany, Ph.D., assistant research scientist.

The UI Public Policy Center fosters interdisciplinary academic research on public policy issues that affect the state and the region. Investigators from a variety of fields and disciplines study policy related to topics such as transportation, health care, economic development, social equity and the environment. The center's Web site is:

For more information about the HAWK-I program call toll-free (800) 257-8563 or visit the Web site

MEDIA CONTACT: Becky Soglin, (319) 335-6660.