1. Hawaii: Updates * Hawaii Covering Kids continues its Rapid Response Team participation through presentations about children's health insurance at meetings for recently displaced employees. Also, thanks to our partnership with Hawaii State Department of Human Services (DHS) and Hawaii State Department of Labor and Industrial Relations (DLIR), a message will appear with unemployment checks beginning 19 May 2009 to help recipients access information about free health insurance for their children. More details and a recent publication "QUEST IS Best 2008 Media Outreach Report" are on our Outreach to Laid-Off Workers web page. * Keiki Care legislation passed. It extends the program to June 30, 2012 and requires primary care services delivered through federally qualified health centers. The appropriation was scaled back to $200,000 for each year of fiscal biennium 2009-2011. This will cover 600 kids annually which is 30 percent of the previous Keiki Care enrollment. Updates are continually posted on the Keiki Care web page. * Hawaii Covering Kids recently published a Fijian flyer, Flyers are now available in 21 languages. 2. National: CHIP Information Several new reports from Families USA and the Center for Children and Families are available along with two CMS letters to Medicaid directors. They include details about state performance bonuses, Links are on the CHIP Reauthorization web page. 3. National: Harmful Impact of Documentation Requirement Reduced for Children The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) enacted in February contains several provisions to reduce the harmful impact of Medicaid's citizenship documentation requirement, which has caused many eligible citizen children to lose or be denied coverage since its 2006 enactment. By implementing these changes immediately, states can lighten the burden that the requirement imposes on otherwise eligible families. Under the documentation requirement, most U.S. citizens applying for Medicaid or renewing their coverage must prove their citizenship by submitting a passport or a combination of a birth certificate and an ID. The requirement's goal, according to sponsors, was to keep illegal immigrants from fraudulently enrolling in Medicaid. (Certain immigrants who are in the United States legally are eligible for Medicaid; the requirement does not affect them.) Yet in many areas, the requirement has impeded or delayed coverage for significant numbers of eligible U.S. citizens, many of who lack the required documents. To help address this problem, CHIPRA: * Requires states to provide coverage to applicants who meet all other eligibility requirements while they secure the documents needed to meet the documentation requirement; * Exempts from the documentation requirement all infants who received automatic Medicaid coverage because their mothers were receiving Medicaid when they were born; and * Requires states to accept documents issued by federally recognized Indian tribes to meet the documentation requirement. Click on the link above for more details about these initiatives. [Donna Cohen Ross and Judith Solomon, Center on Budget and Policy Priorities, 04/23/09] 4. National: Rockefeller Reintroduces Legislation to Cover All Kids by 2015 For years, U.S. Sen. Jay Rockefeller has lobbied for every child in the United States to receive free health insurance under his "MediKids" legislation. To Rockefeller's frustration, the proposal has never gained much traction. Now with health care reform a top priority of the Obama administration, providing insurance for every child seems like a more feasible proposition. Rockefeller, D-W.Va., is reintroducing "The MediKids Health Insurance Act," which would offer benefits similar to those currently covered by Medicaid, including screening and prevention services. "It is appalling to me that any child in America doesn't have access to the health care they need and deserve," Rockefeller said. "Kids have to be covered--period. This is a goal that our president agrees with and wants to see in action." Rockefeller also has some pull in pushing the bill as the chairman of the Senate Finance Subcommittee on Health Care. Eligibility for MediKids would be phased in with children born after Dec. 31, 2009 if the bill were passed. By 2015, the legislation would provide every child in the country access to continuous health insurance. All children would be automatically enrolled, but they could opt out and receive coverage through a private provider. Parents would be charged a small monthly premium for children covered by MediKids. The money would be collected when parents filed their annual income tax returns. MediKids wouldn't supplant private insurance or public insurance for low-income children such as the Children's Health Insurance Program or Medicaid. It would mostly benefit children who don't qualify for Medicaid or CHIP but also are not covered through their family's private insurance. Rockefeller believes the country is moving in the right direction in covering uninsured children. "Our success in expanding Medicaid and passing CHIP was a significant step in the right direction," he said. "However, Congress cannot declare that our work is done because we still have millions of children who are without insurance, and some who are not getting the proper care that they need." Families below 150 percent of the poverty level would have access to care with no premiums or co-pays. Those living between 150 and 300 percent of the poverty level would have a graduated premium of up to 5 percent of their incomes and a refundable tax credit. Families above 300 percent of the level would pay a premium equivalent to one-fourth of the average annual cost per child. There are about 9 million uninsured children in the country, according to the most recent figures. Groups such as the American Academy of Pediatrics are endorsing Rockefeller's bill. Dr. Jay Berkelhamer, former president of the academy and current chief academic officer at Children's Health Care of Atlanta, says now is an opportune time to set these changes in motion. "This is the first time when Congress and the president are both committed to health care reform," Berkelhamer said. Berkelhamer, a pediatrician in the Atlanta area, said he's pleased Rockefeller hasn't given up on the bill. The doctor deals almost constantly with uninsured children. "If parents don't have insurance for their child, they delay taking them to the doctor," Berkelhamer said. "And when they do go, they don't go to a doctor's office. They go to the ER. By this time, illnesses progress and they require more treatment. The children aren't getting the simple care when they need it." [Jake Stump, Daily Mail Capitol Reporter, 05/07/09]