1. New Federal Citizenship/Alien Status Requirements Our Process Simplification Task Force has been working feverishly since the law passed in March. Our goal is to assure Hawaii complies with this draconian Congressional mandate AND eligible people receive their public health insurance benefits. We have many local federal, state, and community partners assisting us and more details are at New U.S. Citizenship Requirements. 2. Three Out of Four People at Risk Under West Virginia's Medicaid Changes are Children Children will be put at risk of losing basic and essential health services under a new West Virginia Medicaid initiative, according to an analysis released today by the Center for Children and Families (CCF) at Georgetown University's Health Policy Institute. West Virginia is one of the first states in the country to make significant changes to its Medicaid program under the recently enacted federal Deficit Reduction Act. The initiative would reduce Medicaid beneficiaries' access to medical services -including mental health services, diabetes care, and some prescription drugs--if they are judged to be out of compliance with a range of behavioral requirements. "West Virginia has entered uncharted territory by seeking to encourage healthful behaviors using the "stick" of cutting coverage for needed health services when someone does not live up to the government's expectations," explains Cindy Mann, Executive Director of CCF. "The implications of this kind of strategy are worrisome for all people who might have trouble following a diet or keeping appointments. They are particularly troubling under the West Virginia approach because this plan primarily affects children." The West Virginia plan was approved quickly by the Administration and touted as empowering patients to make educated, consumer-driven health care decisions related to their own treatment, but the CCF report explains that three out of four of the people affected are children. "Children are not in the driver's seat when it comes to their health care," said Joan Alker, Senior Researcher at the Center for Children and Families and co-author of the report. "Three-year olds cannot direct their own health care, and yet, they are the ones who will lose coverage if their parents have difficulty meeting the requirements." A fact sheet is available in PDF format: Emerging State Health Policy Issues. 3. Will Congress Stymie the Success of CHIP? The state Children's Health Insurance Program (CHIP) is a government success story: it covers more than 4 million children, and has helped spark a 25% drop in the number of uninsured kids since its creation in 1997. The original legislation funded the program for 10 years; now, it must be reauthorized by 2007. A proposal in Congress would "freeze" federal funds for the program at current levels--leading to shortfalls in state funds. States would have to make up the gaps by spending more state money on the program, or cutting back its reach. As advocates gear up to make the case for CHIP, the Center on Budget and Policy Priorities has the lowdown on the proposal, and which states would be hardest hit. 4. Cover Tennessee Governor Phil Bredesen signed the bill that will include CoverKids for children to age 18 and pregnant women effective early 2007. With expected federal approval, this will become Tennessee's mostly federally funded State Children's Health Insurance Program (CHIP), which all other states already have. About 150,000 children statewide are uninsured. It will be free for children up to age 18 and pregnant women in households with income up to 250% of federal poverty level (about $50,000 for a family of 4). Others may enroll and pay premiums. It will provide comprehensive coverage similar to the state employee health plan. (Mid-South News, 16 June 2006) 5. Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences, and Remedies This Commonwealth Fund report examines the extent, causes, and consequences of instability in public coverage programs for children and families. It focuses particularly on the phenomenon of "churning," which occurs when individuals lose and regain coverage in a short period of time. It also looks at strategies to make public program coverage more stable for children and families. Findings are drawn from a variety of sources, including national and state-based studies, roundtable discussions and interviews with stakeholders and experts, and an examination of the affect of state and local policies on instability and churning in four states: Louisiana, Rhode Island, Virginia, and Washington. The experiences of these states demonstrate that coverage instability can be averted to a significant degree by adopting key policies and procedures, like limiting the frequency of required renewals; developing easy, seamless transitions among public coverage programs; and setting affordable limits on premium costs.