What's Happening in the States
States are facing new barriers in providing health coverage to uninsured children and families. Not only is the weakening economy creating fiscal problems for states, but CMS issued a controversial directive in August of 2007 that makes it difficult, if not impossible, for states to use federal funds to cover children with family income above 250 percent of the federal poverty level. Despite these setbacks, states remain remarkably determined to find ways to cover more children.
(11/19/08)
Court Drops NJ August 17th Directive Lawsuit
On November 17th, a US District Judge dismissed the state's lawsuit against the Bush administration SCHIP limits imposed by the August 17th directive, which made it difficult, if not impossible, for states to use federal funds to cover children above 250% FPL. In dismissing the case, the judge ruled that because the Administration had notenforced the changes, there was no reason for the court to intervene.
Court Drops NJ's Federal Suit Over Limits on Kids' Health Care, Newark Star Ledger, November 18, 2008
More on the August 17th Directive
(11/5/08)
Montana Voters Overwhelmingly Approve Kids' Health Coverage Expansion
In a push to cover nearly all children in the state, the Healthy Kids Plan will expand Medicaid eligibility to 185% and SCHIP eligibility to 250%. The initiative also allows for premium assistance to families with employer-sponsored coverage. Voters approved the ballot initiative with 69% of the vote. Healthy Montana Kids
Children's Health Initiative Expected to Gain Voters' OK, Billings Gazette, October 29, 2008
(11/4/08)
Kentucky Eases Enrollment Procedures
In an effort to reach more eligible children, families in Kentucky are no longer required to apply for Medicaid in person. Parents seeking to enroll their child are now able to get applications and other program information online or through a toll-free number. New Kids' Health Web site - www.kidshealth.ky.gov
Parents Can Get KCHIP Information, Forms Online, Louisville Courier-Journal, November 4, 2008
(10/17/08)
Hawaii Ends Universal Child Coverage Program
Governor Lingle (R) has eliminated funding for Keiki Care, the universal coverage program launched in April. The state's private partner in the initiative, the Hawaii Medical Service Association, will pay to extend coverage for the 2,000 enrollees through the end of the year. State Cuts for Keiki Insurance Stun Officials, Honolulu Star Bulletin, October 17, 2008
HMSA to Continue Keiki Care Plan for Uninsured Kids, Press Release, October 16, 2008
(10/14/08)
Restrictive Eligibility Rules in Georgia Prevent Coverage for Children
The number of children covered by Medicaid and PeachCare has dropped by more than 100,000 in the past two and a half years. This decline in enrollment is likely due to tightened rules related to citizenship identification, income verification, and a cumbersome application process in both programs. Children Left Behind on Health Care, Atlanta Journal-Constitution, October 12, 2008
(10/1/08)
Two States Expand Eligibility for Children, One State Decreases Eligibility for Parents
On October 1, Indiana expanded SCHIP eligibility to 250% of the FPL. The state estimates that approximately 10,000 additional children will receive coverage. North Dakota also expanded SCHIP eligibility; increasing the income threshold for children from 140% to 150% of the FPL. In Rhode Island, parent eligibility was rolled back from 185% to 175% of the FPL. Indiana Hoosier Healthwise
North Dakota Healthy Steps
Rhode Island RIte Care
(9/23/08)
Governor Schwarzenegger Signs State Budget with Serious Implications for Children's Health Coverage
The Legislature passed a state budget that rejected the Governor's proposed eligibility decreases for parents and lawful immigrants. However, they did establish mid-year renewals for children, which the state estimates will result in 175,000 children losing their coverage by 2010. In addition, premiums in Healthy Families were increased by $2 to $3 per child, per month. Governor Schwarzenegger Signs State Budget with Budget Reform, Press Release, September 23, 2008
Legislature Passes Budget that Reverses a Decade of Progress in Covering Uninsured California Children, 100% Campaign and PICO Press Release, September 16, 2008
(9/19/08)
CCF Report: Nineteen States Moved Forward in 2008
Many states are moving forward to cover children and some are closing in on the finish line, ensuring that all children have the health coverage they need. Efforts in 2008 to cover children occurred within a diverse group of states, including those in all regions of the country, in both urban and rural areas, and in states with leadership on both sides of the political aisle. This positive activity on behalf of children continues a four-year trend. States Moving Forward: Children's Health Coverage in 2007-08
(9/4/08)
Kentucky Reaches Out to 35,000 Eligible but Unenrolled Children
On September 3, 2008, Governor Beshear (D) announced an initiative to reach an additional 35,000 eligible, but uninsured children in Kentucky. Starting November 1, 2008, the state will no longer require a face-to-face interview at enrollment, allowing families to apply by mail. The application itself will also be simplified and available online. The state will also implement measures designed to improve retention and outreach. Op-Ed: Reversing Course on Children's Health, Louisville Courier-Journal, September 14, 2008
Beshear Cuts Red Tape for Kids' Health Insurance, Lexington Herald-Leader, September 4, 2008
Beshear Announces Plan to Enroll More Children in Health Insurance Program, Press Release, September 3, 2008
(9/3/08)
States Cover More Uninsured Children and Families
On September 1, 2008, two states, New York and New Jersey, implemented eligibility expansions for children and families. New York expanded eligibility in Child Health Plus (SCHIP in the state) from 250% to 400% of the FPL, using state-only funds. In New Jersey, parent eligibility was increased from 133% to 200% of the FPL in NJ FamilyCare. New York Child Health Plus
New Jersey FamilyCare
(7/2/08)
State Update: New Jersey Mandates Coverage for Children and Expands Coverage for Parents
Governor Corzine (D) signed the state's FY09 budget on June 30th, providing $8.9 million in funding for an expansion of NJ FamilyCare (SCHIP in the state). The legislation, which he is also expected to sign, will increase the income eligibility level for parents from 133% of the Federal Poverty Level (FPL) to 200% FPL, reaching approximately 25,000 new enrollees in the first year alone. The bill also requires all uninsured children to obtain coverage, either private or public, within one year of the bill's enactment. Changes were also made to the individual market to make coverage more affordable for younger residents.The bill is the first phase of a comprehensive health care reform package proposed by Senator Vitale (D) that, when fully implemented, will ensure universal coverage in the state.
A Move Toward Universal Health Care One Step Away, Asbury Park Press, June 24, 2008
N.J. Mandates Health Insurance for All Children, Bergen Record, July 9, 2008
(6/30/08)
State Update: Rhode Island Governor Signs Budget with Potentially Broad Implications
Governor Carcieri (R) signed a $6.89 billion FY 09 budget on June 26th, addressing the deficit through $85 million in cuts to state spending. The legislation reduces the income eligibility level for adults in RIte Care from 185% FPL to 175% FPL, eliminating coverage for 1,000 adults. Effective July 1, 2008, the bill also increases premiums in RIte Care for families between 150% and 250% FPL to a full 5% of income and establishes new premiums for families with income between 133% and 150% FPL.In addition, the budget also allows the Governor to pursue a global waiver for the state's Medicaid program, which would give the state broad authority to restructure Medicaid in exchange for capping program spending for the next five years. The Assembly, however, could block any proposed changes but only if it convenes a special session.
Assembly Approves 2009 State Budget Bill, Press Release, June 19, 2008
House Passes $6.89-Billion State Budget, The Providence Journal, June 19, 2008
(6/23/08)
State Update: BadgerCare Plus Reaches More Eligible but Unenrolled
The state of Wisconsin has enrolled more than 75,500 beneficiaries in BadgerCare Plus since February. The majority of these new enrollees are low-income families, who were eligible prior to the expansion. The state believes the biggest reason for the successful outreach has been the basic message that all uninsured kids are eligible. BadgerCare Swells Post-Expansion: Most New Enrollees Would Have Qualified Under Former Income Limits, LaCrosse Tribune, June 22, 2008
BadgerCare Plus Enrollment Data
(6/23/08)
State Update: 1,217 Sign Up for Illinois All Kids in One Day
The state exceeded the goal of the 1,000 Healthy Kids & Families
campaign on Saturday. Around 400 volunteers at more than 40 locations
in the Chicago area assisted in the enrollment drive, processing 1,217
applications. The event was sponsored by Resurrection Health Care and
the Chicago Sun-Times. 1,217 Sign Up for All Kids Health Insurance, Chicago Sun-Times, June 23, 2008
(6/20/08)
State Update: Kansas Reports $1 Million Spent on Citizenship Documentation
20,000 eligible residents lost their health insurance because of federal rules implemented July 1, 2006, that require Medicaid beneficiaries to provide proof of citizenship. About half of those have reenrollled, with only one person determined ineligible because of citizenship status. The state was forced to hire additional personnel, as the policy resulted in a backlog of applications. "Failed" Federal Policy Costs $1M: State Taxpayers Fund New Anti-Illegal Immigration Checks, Lawrence Journal World & News, June 19, 2008
(5/20/08)
Kansas Expands SCHIP Eligibility
Governor Sebelius (D) signed health care reform legislation that contains nine of the 21 changes recommended by the Kansas Health Policy Authority, including an expansion of HealthWave eligibility. Beginning in 2009, children with family income under 225% FPL will be eligible for coverage and in 2010, eligibility will increase to 250% FPL. Enrollees with incomes above 200% will be subject to an 8-month waiting period. Sebelius OKs Health Reform Bills, The Wichita Eagle, May 20, 2008
Sebelius Remains Committed to Schools, Health Care, Openness in Government; Denies Efforts to Diminish Voter Participation, Senate Replacement Maneuver, Press Release, May 19, 2008
What is the Health Care Package?, Kansas Action for Children, May 3, 2008
(5/16/08)
Indiana Gets Approval for Limited Children's Expansion of Hoosier Healthwise
Indiana enacted legislation in May 2007 to expand SCHIP eligibility for children from 200% to 300% FPL. However, due to the August 17th directive, the state submitted and received CMS approval for a scaled back expansion to 250% gross FPL on May 9, 2008. For children with income above 200%, no standard Medicaid income disregards will be applied, a change from how the program currently operates. These children are also subject to a three month waiting period, a provision already in place in the current program, and will also be subject to a higher premiums than families with incomes up to 200% FPL. The state expects to begin enrolling newly eligible children beginning in October 2008. Indiana State Plan Amendment #6
Feds Approve Indiana Plan to Expand SCHIP Coverage, Chicago Tribune, May 9, 2008
(5/14/08)
Iowa Governor Signs SCHIP Expansion
On May 13th, Governor Chet Culver (D) signed bipartisan legislation that aims to provide coverage for all of Iowa's children by 2010. HF 2539 includes an expansion of hawk-i (Iowa's SCHIP program) to 300% of the FPL, 12 months continuous eligibility in Medicaid, and other measures that aim to eliminate red tape so that families more easily enroll and maintain their children's health coverage. Culver Endorses Coverage for All Kids, Des Moines Register, May 14, 2008
Governor Aims to Make Iowa "Healthiest State in the Nation," Press Release, May 13, 2008
(5/2/08)
Rhode Island Cuts Coverage to 2,800 Immigrant Children
In order to close a $168 million deficit, the Rhode Island FY 2008 Supplemental Budget makes widespread cuts across state government. The Governor's proposed eligibility decrease for adults from 185% to 133% FPL was not included in the final budget; however, it does eliminate RIte Care health coverage for more than 2,800 immigrant children that had been grandfathered into the program. Senate Approves Supplemental Budget, Press Release, May 1, 2008
Proposed Cuts in Health Care Protested, Providence Journal, January 24, 2008
(4/29/08)
Colorado Budget Includes SCHIP Expansion
Governor Ritter (D) signed a budget bill on Monday that included an expansion of CHP+ from 205% to 225% of the Federal Poverty Level through SB 08-160. In addition, funds were allocated to provide medical homes to approximately 100,000 Medicaid and CHP+ children, to simplify the application process, and for additional outreach through SB 08-161. It's Official: $17.6 Billion Budget, The Denver Post, April 29, 2008
Governor Ritter Signs Signs Fiscal 2008-09 Budget Into Law, Governor's Press Release, April 28, 2008
(4/15/08)
Texas Advocates Celebrate Gains in SCHIP Enrollment
Last year, Texas enacted legislation that included a number of changes to simplify their SCHIP program including returning to a 12-month continuous eligibility period, allowing families to claim more in child-related expenses, and increasing the amount of assets families could have in qualifying for coverage. The full effect of these policy changes is evident in the April enrollment numbers, which show that the number of children enrolled in SCHIP has grown by more than 108,000 children in just 8 months. Can Do: Hospitals, Businesses and Advocates Took Politics Out of Health Insurance and Covered 100,000 more Kids, Houston Chronicle, April 11, 2008
Texas Enrollment in Children's Health Insurance Program Surges 7%, Dallas Morning News, March 11, 2008
(4/10/08)
New York Expands Health Care Coverage to All Uninsured Children
Governor Paterson and the State Legislature agreed on April 9, 2008 to use state funds ($19 million) to expand Child Health Plus eligibility from 250% to 400% of the FPL. New York originally planned to use federal SCHIP funds for the expansion but due to the directive, CMS denied the states plan. Governor Paterson Announces State Budget Expands Health Care Coverage to Every Uninsured New York Child, Governors Press Release, April 9, 2008
Lawmakers Approve New Health Care Plan, Rochester Democrat and Chronicle, April 2, 2008
(4/3/08)
Oregon Plans to Institute 12-Months Continuous Eligibility
Governor Kulongoski (D) announced during his State of the State address that as of January 1, 2009, the eligibility period for children in the Oregon Health Plan will be extended from 6 months to 12 months. The Governor also announced his intention to reintroduce an initiative, which failed to pass last year, to extend coverage to all kids. Oregon Governor to Revive Healthy Kids Initiative, The Oregonian, March 22, 2008
Healthy Kids Summary Document, Governor Kulongoski
(3/31/08)
Utah Ensures Open SCHIP Enrollment
On March 19, Governor Huntsman (R) signed into law HB 326
which requires that the state keep enrollment in the states SCHIP
program open. SCHIP open enrollment in Utah has been irregular in the
past, beginning in December 2001, when the state first capped
enrollment. With the passage of HB 326, any eligible child that applies
for the program is now guaranteed coverage. Open Enrollment: Moving in the Right Direction, Jerry Cochran, Voices for Utah Children, January 2008
Proposed Bill Would Quarantee CHIP Coverage, The Salt Lake Tribune, January 26, 2008