More states firm up their plans for using federal funds to cover uninsured children
Fed Funds / Uninsured Kids
October 31, 1997
The governors of Pennsylvania, New Jersey and Michigan have thrown their support behind plans to offer health coverage to uninsured children in their states through insurance subsidy programs rather than major Medicaid expansions.
In Wisconsin, state officials are hoping to support their " welfare to work" program by covering 27,400 parents as well as 21,600 children under its Badger Care program. Contingent on obtaining waivers to the Medicaid program from the federal government , the plan would help provide health coverage to parents who don’t have Medicaid or are losing it because of the welfare to work program.
According to Amie Goldman, analyst for the Legislative Fiscal Bureau, parents and children below 143% of the federal poverty level (FPL) could obtain a set of benefits identical to Medicaid from a Medicaid managed care plan under the state’s Badger Care program. There would be no cost-sharing at that income level. Residents with incomes between 143% up to 185% of FPL could also join the program, but with cost-sharing. Parents and children who meet those income guidelines would be able to remain in the program if their income rose to up to 200% of FPL.
Ms. Goldman said the state would have enrollment periods and that parents could enroll within 30 days of becoming employed. If the state obtains necessary waivers, it hopes to implement the plan July 1, 1998.
Among the waivers being sought by Wisconsin include waivers to begin cost-sharing at 143% of FPL instead of 150% of FPL and to allow parents whose children’s have been placed outside their homes to continue to receive benefits. Ms. Goldman said the state wants those parents to be able to receive mental health and substance abuse benefits so that the families can eventually be reunited.
In New Jersey, Gov. Christine Todd Whitman has proposed spending $136 million a year, including more than $90 million in federal funds, to provide health insurance to an estimated 100,000 additional children, about 40% of the uninsured population in that state.
The state would provide managed care for uninsured children in families with incomes between 133% and 200% of the FPL through a new program called New Jersey KidCare. Children up to the age of 18 from households with incomes up to to 133% of FPL would be eligible for Medicaid, under the governor’s plan.
Families who are not eligible for Medicaid would pay a subsidized monthly premium to cover their children through New Jersey KidCare. The family share would equal no more than 2% of a family’s income. To discourage employers from dropping existing coverage for their employees, the program would only be available to children who have been uninsured for at least 12 months.
New Jersey currently operates a subsidy program for families called Health Access, but the program is closed to new applicants and funding is set to run out at the end of this year, according to Eleanor Seel of the Senate Health and Human Services Committee.
Pennsylvania’s Gov. Tom Ridge surprised many critics by announcing plans to dramatically expand the state’s child’s health-insurance program, known as Child Health Insurance Program (CHIP). Gov. Ridge proposed tapping an estimated $600 million in federal funds available to the state over the next five years by providing all of the necessary state match money.
Child advocates estimate that the new money could insure an additional 81,000 of the 330,000 uninsured children in the state. The five-year-old CHIP, which is funded by a dedicated 3-cent share of the state tax on cigarettes, currently covers children in families up to 185% of FPL. Under the governor’s proposal, children up to 200% of FPL would qualify for the subsidized coverage. CHIP now has 1,700 children on its waiting list, a backlog which should be eliminated by the end of November, the governor said.
The governor has not yet announced where the state will get the matching funds, but Scott Johnson, executive director of the Senate Public Health and Welfare Committee, noted that the state "has the luxury of having a surplus."
Michigan’s Gov. John Engler has proposed covering up to 156,000 uninsured children through the Michigan Children’s Health Plan. The program would be open to children who are not eligible for Medicaid and who come from households with incomes up to 200% of FPL. The plan calls for a $96 annual co-pay per child with a maximum of $192 per family per year.
Elsewhere, California Gov. Pete Wilson signed legislation this month creating the Healthy Families program. Two-thirds of the program’s $500 million in funding for the first year will come from the federal government. The program will cover an estimated 580,000 children whose household income is between 100% and 200% of FPL.
Under the program families will pay a monthly premium of between $7 and $27 a child, depending on their income and the plan they choose. The governor also signed legislation aimed at boosting enrollment in Medi-Cal, the state’s Medicaid program, by streamlining the application process and launching an outreach effort.
In Oregon, state officials say they hope to use the new federal funds to both expand the state’s Medicaid program and to create a new subsidy program. The subsidy program would help employees buy health insurance through their employers. Plans call for the subsidy program now to cover families with income up to 170% of the poverty level, instead of 150%.
Elsewhere,
• Connecticut’s governor has proposed expanding Medicaid to 185% of FPL through age 18 and covering children up to 300% of poverty through a new subsidy program.
• Colorado plans to launch a new program Jan. 1, 1998 to cover uninsured children up to 185% of FPL.
• New Mexico officials have proposed expanding Medicaid coverage to 235% of FPL.
• Rhode Island plans to use the federal funds to cover part of the Medicaid expansion costs for children to age 17, up to 250% of FPL.
More states firm up their plans for using federal funds to cover uninsured children
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