Yes We Can' ' ' Cover 4 Million Uninsured Children

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Yes We Can. . . Cover 4 Million Uninsured
Children

• Jennifer Sullivan, MHS
• Senior Health Policy Analyst
• Families USA
• 202-628-3030
• jsullivan_at_familiesusa.org
• Families USA Health Action Conference
• January 29, 2009

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Key Questions

• How much longer until CHIP is reauthorized?
• Whats in the bill?
• What does it mean for my state?

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Background

• Hi, Im new here.
• What is CHIP?

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How much longer until CHIP is reauthorized?

• House bill already passed with 289 votes
• Senate bill passed in committee, floor vote
  scheduled this week
• Conference committee

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What does the House bill (H.R. 2) do?

• Reauthorizes CHIP through end of FY 2013
• Covers 4.1 million uninsured children
• Pay-for 61-cent increase in federal tobacco tax
• Cost 32.3 billion over 4.5 years

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Who Does It Cover?
Total 4.1 million uninsured children
Source CBO Preliminary Estimate of Changes in
SCHIP and Medicaid Enrollment in Fiscal Year 2013
of Children Under the Children's Health Insurance
Program Reauthorization Act of 2009, January 2009.
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Financing
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Financing

• Funnels funding to states that use it
• Allotments available two years
• Contingency fund
• 2009 allotments are an average 96 higher under
  the new formula than under current law

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Who is eligible?

• Children different matching rate depending on
  income (above/below 300 of poverty)
• Pregnant women no waiver needed
• Legal immigrant children and pregnant women
  newly eligible, no 5-year waiting period
• Parents new restrictions
• Childless adults new restrictions

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Getting more children enrolled

• Performance Bonuses
• Medicaid enrollment benchmarks
• Qualifying activities
• 12 month continuous eligibility
• Eliminate asset tests/allow administrative
  verification
• Eliminate face-to-face interview requirements
• Presumptive eligibility
• Single Medicaid/CHIP application
• Express lane eligibility
• Passive/ex-parte renewal

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Getting more children enrolled

• Express Lane Eligibility
• 100 million in outreach grants

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Other improvements

• Benefits
• Dental coverage
• Mental health parity
• Clarifies EPSDT required in benchmark plans
• Quality
• Improved quality measurement
• Electronic medical records for children
• Child obesity demonstration

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Senate Bill (S. 275)

• Similar to House except
• Performance Bonus Qualifying Activities adds
  premium assistance
• Pay-fors no specialty hospital provision
• Dental wrap for children with private health
  coverage but no dental
• Immigrant documentation requirement
• MACPAC/Trustees report
• Actuarial Soundness study

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What does CHIP Reauthorization mean for states?
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What does CHIP Reauthorization mean for states?

• Stable funding through 2013, but . . .
• Use it or lose it.

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Are states ready to move forward?
States with projected budget deficits in FY2009
or FY2010
Alaska no Hawaii yes
Source Center on Budget Policy Priorities,
January 14, 2009
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What Should I Do When the CHIP bill is signed?
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What Should I Do When the CHIP bill is signed?

• Educate state policymakers about new financing
  rules
• Prevent proposed cuts
• Adopt simplified outreach, enrollment, and
  retention policies
• Adopt express lane eligibility
• Cover legal immigrant children and pregnant women

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Other issues to think about

• Does my state use CHIP funds to cover parents?
• Does my state use CHIP funds to cover other
  adults?

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More information

• Families USA
• www.familiesusa.org
• Stand Up for Health Care
• www.standupforhealthcare.org