1. States Moving Forward: Children's Health Insurance in 2007-2008 A new report by the Center for Children and Families finds that despite a weakening economy and growing fiscal strains, states have continued to move forward in their efforts to expand and improve health insurance coverage for children. It can be downloaded in PDF format at: * 19 states moved forward during 2008, implementing changes authorized in 2007 and/or adopting new measures to expand and simplify their Medicaid and CHIP programs. * This positive activity on behalf of children continues a four-year trend with two-thirds of states making significant improvements in their Medicaid and CHIP programs since 2005. * In 2008, two states made significant budget cuts or program changes negatively affecting child and family coverage. However, with 9 million uninsured children in the country, much more needs to be done. To ensure the forward movement on children's coverage continues the country must secure and strengthen the public programs that are critical to the coverage of our children. 2. America's Agenda: Health Care for Kids A nonpartisan organization of labor and business leaders has launched a multimillion dollar campaign to persuade Congress to extend the popular and effective State Children's Health Insurance Program (CHIP) to reach another 3 million low-income children. CHIP currently covers more than 6.6 million children in the United States, but 9 million more kids still lack health insurance. 3. Recent State Efforts to Expand Children's Health Insurance Over the past year, 19 states have taken significant strides toward covering more children despite challenging fiscal times. At a National Health Policy Forum last week, three states explained their progress. Here are details of what they've done: Louisiana has made significant progress in covering kids in recent years by expanding coverage through public programs (Medicaid and the State Children's Health Insurance Program) and making it easier for families to sign up. It also has become the very best state in the country at "plugging the hole in the bucket." While it is not uncommon for states to lose about one-third of their children when they come up for renewal, Louisiana loses fewer than one in a hundred kids--less than one percent. It took leadership from the state's political leaders and a commitment to changing the workplace culture of eligibility workers, but, otherwise, nothing too fancy. The secrets? Families no longer have to pull together copies of eight consecutive pay stubs when applying for coverage, they can renew by phone, and, whenever possible, the state uses information it already has on hand from other state programs to figure out when children remain eligible for coverage. Pennsylvania also was in the spotlight for its Cover All Kids Initiative, which provides "all children" (undocumented children remain ineligible) with access to affordable, quality health care. Under the initiative, children at lower income levels can qualify for a public program known as the Children's Health Insurance Program (paying premiums at more moderate-income levels), while other families can buy in at full cost. The "all kids have a place to go" strategy has been critical to the state's success. Only one percent of the kids who have signed in Pennsylvania are in the full cost part of the program. As interestingly, by laying out the welcome mat and making sure that all families know they have a place to go, Pennsylvania signed up thousands of low-income kids who were already eligible for public coverage. Turns out it isn't necessary to pick between focusing on covering the poorest kids in a state versus those in more moderate-income families. A "cover all kids" initiative helps both groups of families. Iowa is earlier in its process, but setting out to cover all children by expanding eligibility and making it easier for families to enroll in and keep coverage. It's signed up two former Governors Vilsack (D) and Branstad (R) to work on the issues and is well on its way. By July of 2009, it will have expanded coverage to more children and have a plan--developed through the collaboration of many diverse stakeholders--to get all children covered. It is worth noting the dark spots raised by forum participants. They are: (1) weak economy, (2) Bush Administration's decision to veto reauthorization of the State Children's Health Insurance Program, and (3) out-of-the-blue (the General Accounting Office and the Congressional Research Service say it's illegal) Bush Administration policy designed to prevent states from expanding coverage to children in more moderate-income families. Given these significant challenges, not all states can do it. Indeed, California recently decided to plug its budget hole in part by imposing more paperwork requirements on families seeking to keep coverage for their children, as Sarah Arnquist discussed earlier this year. Critics are warning that up to 250,000 children will lose coverage as a result. But, for now, at least, an impressive array of states is still moving forward, reflecting the powerful political and moral imperative to cover the nation's children. [Jocelyn Guyer, The Health Care Blog, 09/25/08]