A free health insurance program for children and youths is being expanded by the state in the hopes that 9,000 who are currently uninsured will gain coverage.

The state recently raised the income limits for eligibility, allowing more families to qualify for the coverage of their children under age 19. Families of four can now get the Med-Quest health insurance if they earn up to $59,400 annually. That's a 29 percent increase from the previous $46,008 income ceiling.

The state also added a new program that helps middle-income families. If families of four make less than $71,280, they can qualify for low-cost health insurance for children.

"It should benefit a lot of people," said Michelle Malufau, an eligibility outreach worker at the Ko'olau Loa Community Health and Wellness Center in Kahuku.

"We had a lot of people who are self-employed who didn't qualify. So the kids went without health insurance, just using the free clinic and emergency room if it became an emergency."

The state currently covers 102,501 children through Quest, which is the Hawai'i Medicare program. Barbara Luksch, project director for Hawai'i Covering Kids, a group that promotes use of Quest, said the state worked with the federal government to raise eligibility income limits and on the new program for middle-income families. It can potentially provide coverage for 9,000 of the estimated 16,000 children and youths in the state who don't have health insurance.

She said income limit had been tied to the federal poverty level set for the state. Recently that increased because of inflation. Federal officials also agreed to Quest modifying the formula for setting the ceiling.

Previously it was twice the federal poverty level; as of Jan. 1, it rose to 2.5 times the level. That will help more families qualify to have their kids covered through the state program, Luksch said.

"It's much better economically to have them in health insurance than to have them go to the emergency room," Luksch said. She said she recently came across a family who couldn't afford the insurance and had a child with asthma stay out of school two weeks as he tried to get better. The child eventually ended up in the emergency room.

The family since met with an outreach worker, and their children qualified for free coverage under Quest. The asthma is now being treated by a regular pediatrician, Luksch said.

"It's better to have them grow up healthy," Luksch said.

The new middle-income program sets the income ceiling at three times the federal poverty level. Families who normally pay $600 or so a month for children's medical coverage can qualify for insurance that costs $5 to $60 a month per child, depending on their income.

Malufau said she recently helped a family of six and two families of four qualify for Quest coverage after failing under the old limits. The coverage includes medical and mental health services available through Quest providers. There also is dental coverage under the Medicaid fee-for-service program.

"One of the families really wanted to get the kids to the dentist since they haven't been," Malufau said.

Reach Greg Wiles at gwiles@honoluluadvertiser.com.