By Angela Toda
Marketing and Communications Administrator
INTERNATIONAL COMMUNITY HEALTH SERVICES (ICHS)

Nita Ticman
Monday through Friday, Nita Ticman drives her two youngest children through morning traffic from their Lynnwood home to school in Shoreline. Each morning, the tiny brown-eyed Filipino American mother of three returns, knowing she’ll need to be back in time for afternoon pick up.
There’s not a lot of “me time” in her day, which is tightly orchestrated between work at an assisted living facility and moving from one family commitment to the next.
“You have to cook, you have to clean the house, everything. That’s my life,” she said. “I don’t forget to go to church every Sunday, that’s it. That is the routine of my life.”
Ticman’s story echoes millions of busy moms who struggle to do it all. Now, her balancing act and her family’s security may be jeopardized with threats to a highly successful federal program that enrolls thousands of Washington state children, many of whom are the children of Asian immigrants, in affordable health insurance.
When her husband had problems lifting heavy machinery at his King County job, the family was glad he could find another job that was easier on his back. His previous benefits included a generous health insurance policy. His new one has premiums costing nearly $1,000 a month.
A patient at International Community Health Services (ICHS) since 2000, Ticman decided to see one of the health center’s enrollment specialists about affordable options for health insurance. As a part-time worker, she has health benefits for herself, but none for her family.
“I went to ICHS, my primary doctor is there. I asked her if I can get an appointment to start insurance again for my children, for my son and for my daughter. My daughter is 17 and a half. My son is only 13 years old,” said Ticman.
She met with Sharissa Tkok, ICHS enrollment specialist. Tkok and her team offer free help with insurance enrollment to residents throughout King County. Many speak English as a second language.
The extra step and inquiry bore fruit. Tkok enrolled Ticman’s children into the Washington state Children’s Health Insurance Program (CHIP), which has a higher qualifying threshold for Medicaid eligibility. In 2014, the program covered 42,637 children through Washington Apple Health for Kids. Apple Health does not require cost sharing, meaning those who are eligible just pay a monthly premium. There are no copay, co-insurance, or deductible requirements.
“I was so happy on that day because I got the insurance and only paid $40 a month. It’s a really big help for me,” said Ticman.
Nita’s youngest son is allergic to peanuts. Each year, his school requires the purchase of an EpiPen to keep on campus in case of an emergency. Without insurance, Ticman would have to bear this annual expense on her own. “It’s a struggle for me and for my husband to pay for that,” she said.
Tkok sees many working families in similar positions. Those with modest incomes might earn too much to qualify for Medicaid, but still find it difficult to pay for premiums and co-pays through private insurance or the Washington Health Benefits Exchange. CHIP keeps kids healthy by ensuring continued access to immunizations and preventative care.
“When you are on a limited budget and trying to support a family, it makes a huge difference,” said Tkok.
Unfortunately, this lifeline for Ticman and her family may end soon. Federal funds for CHIP expired at the end of September. Lawmakers, consumed by arguments over “repeal and replace,” allowed the funding deadline to pass without renewal.
“Access to health care is a looming national crisis. Not reauthorizing CHIP and repealing the Affordable Care Act abandons all working adults, families, and their children, preventing them from access to regular care from a doctor or dentist,” said Teresita Batayola, CEO of ICHS.
Washington is one of several states to come up with a short-term fix to keep the program going, but these funds are projected to end in the first quarter of 2018.
According to Leanne Berge, CEO of the Community Health Network of Washington, “Ten years ago, Washington state made a commitment to cover all kids, but our ability to do that is in serious jeopardy without federal CHIP funding. Losing it would be a blow to thousands of families across the state.”
“Putting the health and wellbeing of future generations first should be something we can all agree on,” said Jeffrey Caballero, executive director of the Association of Asian Pacific Community Health Organizations (AAPCHO). “CHIP covers nearly 9 million children nationwide, including 28 percent of Asian American children who rely on CHIP and Medicaid for coverage. If funding doesn’t continue, nearly half of these children will lose access to CHIP coverage, with over 1 million children losing coverage entirely.”
Ticman realizes that her morning commute and many of her current burdens won’t last forever. Eventually, she says, her kids will be able to drive on their own and her youngest may want to go to high school closer to their home in Lynnwood. Until then, she sees her job as doing what is best for them.
“I know it’s a big job for me, but I will do this for the sake of my children. All moms always do the best thing for their children,” she said.
Both Save Health Care in Washington and AAPCHO offer steps to help people take action to protect families like Ticman’s. For more information, go to clinics.savehealthcareinwa.org/take-action oraapcho.org/action-alert/health-center-funding-cliff-2017.
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