How “Cover All Kids” Provided Access to Essential Specialty Care for a Zufall Patient

For 10th grade student Asumi, being a patient at Zufall Health – Dover has meant more than receiving routine pediatric care. With the dedicated support of Pediatrician Christine Pagano, MD, Registered Nurse Maribel Ali, RN, and other providers, Asumi has experienced significant improvements in her self-esteem and quality of life over the past year.

In August 2023, Asumi underwent surgery at University Hospital in Newark that fundamentally changed her life, a decision guided by Pagano’s expertise and made possible by the expansion of NJ FamilyCare (Medicaid) insurance.

“Before the surgery, communication was a struggle, and no one could understand me,” says Asumi, who, in addition to physical health challenges, endured bullying by her classmates due to her speech. “Now, I can pronounce so many more words, and I feel so much better about myself.”

Central to Asumi’s progress was Zufall’s assistance with her enrollment into NJ FamilyCare (Medicaid), the state’s public health insurance program for low-income individuals and families. In January 2023, Governor Phil Murphy expanded eligibility for NJ FamilyCare to all children whose families meet income requirements, regardless of immigration status, as part of the ongoing “Cover All Kids” campaign. This legislation meant that Pagano and Ali could refer Asumi to their colleagues in Insurance Enrollment.

New Jersey Department of Human Services Commissioner Sarah M. Adelman speaks at Governor Murphy’s Cover All Kids press conference at Zufall Health – Morristown in January 2023.

Asumi moved to New Jersey from Peru in 2022. She was born with a cleft palate, a common birth defect that causes an opening in the roof of the mouth due to improper tissue fusion during fetal development. Most children born with a cleft palate undergo reconstructive surgery called palatoplasty within the first year of life.

Without health insurance, Asumi could not access this essential surgery until age 16. Prior to Cover All Kids, Asumi qualified only for NJ Charity Care, a financial assistance program that pays for limited medical services while excluding specialty care and procedures. The palatoplasty wasn’t accessible for Asumi in Peru either, due to high risks and costs, jeopardizing her health for many years.

Timely intervention for a cleft palate is critical. When left unrepaired, a cleft palate can cause significant health issues, including speech difficulties and serious infections from food and drink entering the airways, explains Pagano.

“Before the expansion of Cover All Kids, I often found myself in the distressing position of being unable to refer my patients to urgently needed services,” Pagano says. “It was so heartbreaking to see patients like Asumi unable to access the specialized care in a local hospital that she required. I am very thankful to have been able to provide this important referral.”

Asumi’s mother, Pilar, is also appreciative of the assistance that her family has received. “I am thankful for Dr. Pagano and Maribel because now my daughter can pronounce many words she couldn’t before. She sleeps with her mouth closed, not open. And most importantly, she has so much more confidence,” says Asumi’s mother, Pilar.

“Doctors want to solve people’s problems, relieve suffering, and make a positive difference in people’s lives. Expanding children’s health coverage allows us to do just that,” adds Pagano.

Above, Left to Right: Asumi (center) with her mother, Pilar (right), and her Zufall Health Pediatrician Christine Pagano, MD.

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