1. Hawaii: Impact of New CHIP Law
The Children's Health Insurance Program (CHIP) Reauthorization became law on 4 February 2009 and it is effective 1 April 2009 to 30 September 2013. The overall goals are to continue public health insurance benefits for current recipients and cover an additional four million children and youths who are eligible but not enrolled. Hawaii will continue its coverage up to 300% FPL, receive federal matching funds for its children and pregnant women programs covering lawful permanent residents, be eligible for federal outreach grants, and qualify for performance bonuses through ongoing process simplification and enrolling more kids. For more details and continuous updates, please visit our CHIP Reauthorization web page.
2. Arizona: Ending 6-Month Renewals a Win-Win Decision
It was reported this week Arizona may lose more than $1.7 billion in federal stimulus funding for its Medicaid program, Arizona Health Care Cost Containment System (AHCCCS). This is because of changes made last year by the state Legislature requiring individuals enrolled in AHCCCS to undergo eligibility determination every six months instead of annually.
First of all, Arizona cannot afford to lose this much federal stimulus money, facing as we are a $3 billion deficit for the coming fiscal year. We need this money to help balance our budget. In addition, during the recession more and more people are losing their jobs and their employer-based health care. The number of people qualifying for and needing AHCCCS coverage has increased and is only going to continue to increase in the coming year. We need this money to provide health care to these people during this economic crisis.
Some lawmakers are being disingenuous when they state that the shift to requiring individuals to reapply for AHCCCS every six months instead of once a year is not a change to more restrictive standards. This ploy of requiring more frequent re-enrollment is one of the most commonly used maneuvers by state Medicaid programs throughout the country to limit costs by restricting access to Medicaid. As anyone who has applied for Medicaid or dealt with state agencies knows, it is an often burdensome, onerous and bureaucratic process. Requiring families to re-enroll every six months instead of annually creates unnecessary road blocks that will predictably cause many eligible families to lose their AHCCCS coverage, putting their health at risk.
As a practicing pediatrician, I have seen this happen time and time again when families have trouble re-enrolling for AHCCCS and temporarily lose their coverage, resulting in dangerous delays in receiving preventive and acute health care. This policy also does not save money in the long run. It merely shifts costs from the present to the future, deferring health care now when it is cheaper to provide preventive care and treat health problems earlier, pushing them off into the future when more care will be required and it will more expensive. In addition, this whole issue perpetuates the stereotype that many people on Medicaid are scamming the system and don't belong there. In truth, the opposite is the case.
Studies show that two-thirds of the uninsured children in the country are already eligible for Medicaid or the Children's Health Insurance Program, (CHIP, known in Arizona as KidsCare) but are not enrolled. In Arizona, this represents more than 150,000 children. The real issue is improving outreach and making it easier to enroll eligible children and families, not harder.
The Legislature should reverse the current policy and return to the standard of once-a-year eligibility determinations. This will serve the health of our citizens better and reduce our state budget deficit by $1.7 billion in federal stimulus dollars. For Arizona, this is a win-win situation. [Keith Dveirin, Arizona Daily Star, 03/30/09]
3. Kentucky: Governor Launches KCHIP Campaign
Hoping to get more children into a federal low-income health insurance plan, Gov. Steve Beshear and others kicked off a publicity campaign in Louisville yesterday. "This is critical to Kentucky's future," Beshear said, noting that fewer than half the state's children believed eligible for the program known as KCHIP--Kentucky Children's Health Insurance Program--are enrolled.
Beshear said that the state is working with nonprofit groups such as churches, schools, youth centers and the YMCA to promote a streamlined application process for parents that he hopes will increase enrollment in the Medicaid plan, which now covers about 54,000 children. And Passport Health Plan, a nonprofit entity that provides Medicaid services in Jefferson and 15 surrounding counties, announced yesterday it is launching a media campaign that will include posters, public service announcements and bus advertisements on how to apply for KCHIP. "Our goal is to enroll children throughout our service area," said Dr. Larry Cook, Passport's chief executive officer.
Advocates had long criticized the KCHIP application as too complicated and burdensome for working parents. So in November, Beshear eliminated the requirement for in-person interviews with state workers--allowing parents to apply by mail--and offering a simplified application. Beshear wants to add 35,000 children to KCHIP over the next two years.
The governor said up to 4,000 additional children have been enrolled in KCHIP since the November 1 changes, but he thinks that some of the progress was slowed by January's ice storm, which felled trees and power lines, closed schools and left many communities with no electrical power for days. "Everything ground to a halt for about three weeks," he said.
KCHIP covers children whose parents earn up to twice the federal poverty level--about $42,000 a year for a family of four. Beshear said state officials are still considering whether to take advantage of the expansion Congress approved this year that covers children whose parents earn up to three times the poverty level, or about $63,000 for a family of four. State officials believe another 12,000 children would be eligible under the expansion. The federal government would pay 80 percent of the costs and Kentucky 20 percent. "I definitely want to," the governor said. "We're looking to see how and when we might be able to do that. Even though it's a federal match, you still have to come up with the state portion of the match," he added. [Deborah Yetter, Courier-Journal.com, 03/24/09]
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