1. Enrollment Data for Children and Youth Since January 2004, an additional 3,748 children and youth have been enrolled in Med-QUEST’s programs. Wow! We attribute this dramatic increase to outreach, simplification, and retention efforts accomplished by our community partners and Med-QUEST. To download copies of more detailed enrollment data in PDF format, go to our data page. 2. Primary Care Roundtable Focuses on QUEST and Medicaid Lillian Koller, Hawaii State Department of Human Services director, will present information on her health vision for Hawaii, new DHS developments including health insurance for pregnant immigrants and Hawaii RX Plus, the department's major achievements and challenges, partnerships to provide dental services for adults, and improved timely payments to health care providers. The roundtable is sponsored by the Hawaii State Department of Health on 29 July 2004 from 9:00-11:00 am and will be broadcast via videoconference at sites throughout the state (Hilo, Wailuku, Waimea, Kohala, Kapaa, Kula, Kona, Lanai, Hamakua, Honolulu, Kau, and Maluhia). For more information, contact Josh Hekekia at 733-8359 or josh.hekekia@fhsd.health.state.hi.us. 3. National Enrollment Data One report announces the numbers have gone up and the other explains why they've gone down! Read them both and let me know what you think: a. Health Insurance Improves for Children But Struggles Remain The Centers for Disease Control and Prevention report dramatic increases in health coverage for poor and near-poor children. Coverage for kids just above poverty (up to 200 percent of the official rate) almost doubled from 24 percent to 47 percent between 1997 and 2003 thanks to the State Children's Health Insurance Program (CHIP). These 2003 rates for children's health insurance were the highest since CDC started measuring, however over ten percent of U.S. children remain uninsured and the number of uninsured working-age adults increased. One in seven families, even those with health insurance, had trouble paying medical bills in 2003. The report is at http://www.cdc.gov/nchs/pressroom/04news/insur2003.htm. b. Enrollment Declines in 11 States and DC More Than Offset Increases in 37 Other States At a Kaiser Commission on Medicaid and the Uninsured briefing, two new publications were released reporting that enrollment of children in the State Children's Health Insurance Program (CHIP) declined during the second half of 2003 for the first time since enactment of CHIP in 1997. Enrollment declines in eleven states and the District of Columbia more than offset moderate increases in thirty-seven other states, according to the new fifty-state survey. More than half of the national enrollment decline is attributable to the drop in coverage in Texas. The reports are at http://www.kff.org/medicaid/kcmu072304pkg.cfm. The new report, "CHIP Program Enrollment: December 2003 Update," prepared by researchers at Health Management Associates for the Kaiser Commission on Medicaid and the Uninsured, finds that while annual enrollment in CHIP increased by 4.2 percent in 2003, the increase was less than half the 9.7 percent rate in 2002. A related state case study, "Children's Medicaid and CHIP in Texas: Tracking the Impact of Budget Cuts," prepared by the Center on Public Policy Priorities details the impact of Texas' legislative actions on enrollment in Medicaid and CHIP. One-third of low-income children in Texas are uninsured which is the highest rate in the nation. The case study reviews the enrollment reductions in Texas' CHIP in 2004 and the slowing of enrollment growth in Medicaid for the past two years, in part due to procedural complexities added to the application and renewal process in September 2003 to address the state's budget deficit. "The drop in CHIP enrollment is a major setback when millions of uninsured children are eligible but not yet enrolled in public coverage programs," said Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured. "States have shown that bipartisan initiatives like CHIP can work to reduce the number of uninsured children, but state budget constraints mean even this popular program has not escaped cutbacks." 4. Is CHIP Shipshape? An article in the May 2004 edition of State Legislatures magazine explores how the State Children's Health Insurance Program (CHIP) has responded to widespread state budget cuts. Authors Hy Gia Park and Leah Oliver conclude that despite the enormous success CHIP has had since the program was enacted in 1997, children's health insurance programs are not immune to budget cuts. Six states froze their enrollment to help alleviate budget concerns, enrollment has slowed in many states (a sign of cutbacks in outreach spending), and thirteen states have even experienced a decline in CHIP enrollment. Furthermore, numerous states have scaled back their programs by tightening eligibility requirements and reducing benefits.