Because Vasquez's starting wage was so low, the boys qualified for cost-free Medicaid. Today, Vasquez makes more supervising her store's cosmetics department and Osco provides health insurance for the family. But because her co-payment takes more than $25 weekly from her pay, she's exploring whether her family qualifies for a premium rebate that Illinois offers through KidCare. "I'd never have heard of KidCare if not for the union," Vasquez says.

	All covered: UFCW Local 881 member Gabriele Vasquez says her sons, Michael and Ramon, never would have received health care coverage if it hadn't been for her union.

Of the nearly 11 million children today who do not have health coverage, according to the U.S. Census Bureau, an estimated 4 million are eligible for Medicaid, and another 2.5 million for CHIP, says Kristine Hartvigsen, spokeswoman for Covering Kids, a national health access initiative for low-income uninsured children financed by The Robert Wood Johnson Foundation.

"Primarily, it is a lack of outreach to make families aware of their children's possible eligibility that accounts for underenrollment," she says. "Too many people mistakenly think that if they're earning money, they're not eligible—that's where outreach comes in."

In many different ways, union activists are helping to spread the word about health coverage for children. They're lobbying state officials to simplify often lengthy and intrusive applications and to expand CHIP programs: In Florida, for instance, Unite for Dignity, an organizing campaign of SEIU Local 1115, Florida division of SEIU 1199, has allied with religious groups and medical service providers to persuade state leaders to allow more children of immigrant workers to get CHIP coverage.

		From America@work, January 2001.

Some local unions promote CHIP to assist members through tough life transitions, such as re-entering the workforce after divorce, with organizers giving the information to help stabilize potential new members. The UFCW—which has a tradition of getting benefits for part-time members, according to UFCW Negotiated Benefits Director David Blitzstein—and other unions are looking ahead for more opportunities to expand participation in CHIP. "For the past 50 years, union wages and benefits have raised community living standards and been the ticket for millions of working men and women into America's middle class," says UFCW President Doug Dority. "Union members also give back, building strong communities though their activism, like Local 881 members helping make sure kids have health insurance. Healthy kids mean stronger, more vital communities." Some unions are considering a pilot program that would use CHIP dollars to coordinate coverage through a Taft-Hartley plan (which receives contributions from more than one employer and is jointly sponsored and run by unions and management). Under Taft-Hartley plans, it's possible that CHIP dollars could cover the children of seasonal workers and those with multiple employers.

	Strong communities: UFCW President Doug Dority, shown here at a demonstration supporting Wal-Mart worker's efforts to join a union, says healthy kids mean stronger, more vital communities.

"The rules have changed," says Michelle Sforza, an AFSCME policy analyst. "There is no longer an informal pact that employers care for employees. Labor's efforts to expand universal health coverage do not indicate any failure on its part."

For unions focusing on representing low-paid workers, CHIP can be a valuable organizing tool. Newark, N.J.-based organizers for a new AFSCME district—Home Health Care 1199/AFSCME, National Union of Hospital and Health Care Employees—are spreading the word about CHIP as they contact workers statewide. Now called FamilyCare, New Jersey's program recently expanded to include working-poor parents. "We're meeting 27,000 folks, and we're a nonthreatening source of information," explains Patrick Nowlan, an organizer and director for the new district, which won its first two elections—a total of 381 members—in November.

The union's strategy is to enroll potential new members in existing state programs so their family's medical needs are covered, even before contract bargaining. And 1199/AFSCME organizers always let workers know there is no stigma in participating in a public health care program: "Part of our presentation is telling them the public health agency that provides financing for their boss's and their salary should also provide their benefits, just as the state does for its workers," Nowlan says.

When Nowlan and fellow organizers inform home health care workers about FamilyCare, the workers frequently are surprised that their employers—who have been urging them to pony up premiums for their pricy group plans—haven't told them about it. "Chances are, the employer knew about the CHIP program all along," he says. "It's a travesty when you meet with a worker who is making $7 an hour, trying to make ends meet, and they can't afford family coverage through their employer but enroll anyway, thinking it's their only option."

	Healthy choice: home health care worker Sielta Ramjas's son, Ryan, is covered under CHIP.

Sielta Ramjas, an activist helping to organize her co-workers to join 1199/AFSCME and a home health care worker for 11 years who "loves the work," enrolled her son in Medicaid when he was a baby. Today, he's nearly 8 and in Family-Care. "Originally, I didn't want him in a public program," Ramjas recalls, "but I had no other choice." Ryan has received good medical attention through the years, says Ramjas, whose employer does not provide any dependent medical coverage.

For herself, Ramjas currently has insurance through her job. But she's not happy with the paltry benefits it provides for an $18 monthly premium, and looks forward to getting 1199/AFSCME-negotiated coverage for her and Ryan when she and co-workers become members. "Getting people from Point A to Point B," says Nowlan, "is what unions are about."