1. Uninsured Teens Often Left Out of Medicaid and CHIP A new report entitled "Adolescents in Public Health Insurance Programs: Medicaid and CHIP" released by the Advocates for Youth's Center for Adolescent Health and the Law stresses the need for states to extend eligibility for Medicaid and the Children's Health Insurance Program (CHIP) to uninsured adolescents. Teens and young adults are uninsured at higher rates than other age groups, with more than 2.3 million uninsured adolescents eligible but not currently enrolled in Medicaid or CHIP, the study reports. In addition, the study found that 1.3 million adolescents under age 19 are ineligible for the programs "either because states have not elected to cover them or their family income level exceeds federally allowed limits." The report found that 50% of states "are not yet doing all they could to establish Medicaid and CHIP eligibility levels that would reach as many adolescents as possible." According to the report, states should provide coverage for adolescents up to age 19 in families earning up to 200% of the federal poverty level. In light of the various health problems that many teens face, the report advises states to establish a "comprehensive set of benefits that includes preventive care as well as diagnostic and treatment services." Although Medicaid requires CHIP to provide a benefits package, "many gaps remain in the provision of key benefits for adolescents," including family planning benefits. While many states include family planning services in their CHIP plans, the "comprehensiveness of these services for teens is not yet fully known," the report says. States' Medicaid and CHIP programs should include a range of sexual and reproductive health services and specialized services for adolescents with chronic illnesses and disabilities, the report stresses. In addition, they should assure confidentiality of adolescents' health information and provide complete information about laws related to minor consent and confidentiality. Abigail English, director of the Law Center, said, "American adolescents face serious health challenges, including high rates of suicide, pregnancy, HIV and other STDs, substance abuse, mental and emotional illness and poor nutrition. Each state has the responsibility to ensure that young people get all of the coverage they need." For a copy of the report, please call the center at 919-968-8850 or visit their web site at: http://www.adolescenthealthlaw.org (Source: American Health Line, 3/16/00) 2. Why Do Kids in Families Receiving Welfare Miss More School? Many states are attempting to reduce school absenteeism by cutting families' welfare checks when their children miss too much school. According to an analysis of school absenteeism by Abt Associates, kids from welfare families do miss more school, but usually it is because they are in poorer health than their peers--not because of parental indifference. 3. Improving Outreach for Medicaid and Food Stamps This Mathematica Policy Research review concludes that declines in Medicaid and food stamp participation may reflect differing causes, however, improving enrollments in both might rest on some similar strategies: concentrating on outreach programs, simplifying applications, reviewing closed cases and improving worker knowledge of eligibility rules. 4. HCFA Sends Recommendations to State Medicaid Directors The Health Care Financing Administration (HCFA) sent guidance to state Medicaid directors today on important Medicaid enrollment issues. The information is in the form of a letter and a set of questions and answers available in PDF format: http://www.cms.hhs.gov/smdl/downloads/smd040700.pdf The HCFA materials tell states: 1. What they must do to identify families improperly dropped from Medicaid and the steps states must take to reinstate them in the program; 2. The federal requirements for Medicaid eligibility redetermination for individuals; and 3. The federal requirements for the operation of computerized eligibility systems. These HCFA materials guide states on complying with federal law in preserving or restoring Medicaid coverage for families that left the Temporary Assistance for Needy Families (TANF) program. 5. Supreme Court Allows Denial of Medicaid Benefits to Noncitizens This week the Supreme Court refused to hear a case challenging parts of the1996 welfare law that made some legal immigrants ineligible for federal assistance like Medicaid and food stamps, the Washington Post reports. The challenge to the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 was brought by the City of Chicago and was supported by other cities. One of the arguments made by the City of Chicago was that "the denial of benefits had the effect of an 'unfunded mandate' because state and local governments would have to shoulder a financial burden they previously shared with Washington." According to an American Health Line report, although the 1996 welfare reform law barred immigrants' access to benefits until they had lived in the US for 5 years, Congress has since restored benefits for immigrants younger than 18, for disabled immigrants, and for other groups. In a supporting brief, New York City stated that the 1996 welfare reform law "is really about shifting the financial and social burdens of immigration to state and local governments." A lawyer who wrote a brief supporting the City of Chicago's position for the Center for Law and Social Policy stated that benefits "were an essential lifeline enabling family members to obtain the food necessary to lead an active, productive life [and] consequences of the cutbacks are severe and the effects are continuing." Greenhouse L., 27 March 2000. Justices reject case on cutting welfare for legal immigrants. Washington Post. Biskupic J., 28 March 2000. Washington Post. Challenge to welfare reform act rejected. National Journal's Daily Briefing. Supreme Court: Upholds denial of benefits to noncitizens. 28 March 2000. American Health Line.