Closing the Gap for Ohios Children and Families

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Closing the Gap for Ohios Children and Families

• November 28th
• Ohio Covering Kids and Families

Mary D. WachtelVoices for Children of Greater
Clevelandwww.voicesforclevelandschildren.orgmary
.wachtel_at_voicesforclevelandschildren.org614.648.1
450
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Who We Are

• Voices for Children (Voices)
• An independent advocacy organization with over
  100 members
• We give voice to the needs of children
• Ohios only affiliate of Voices for Americas
  Children

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A look at Ohios Medicaid/SCHIP Program

• Ohio Medicaid covers
• 1.76 million Ohioans
• 1.3 million of those are in Covered Families and
  Children (CFC)
• Including about 950,000 children and 350,000
  parents
• About 440,000 are Aged, Blind and Disabled
• 1 in 3 births
• Nearly 1/3 of all Ohio children

Source ODJFS, OFS, Bureau of Budget Management
and Analysis (2006 report)
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A Look at Where Weve Come From Children
Sources National 1998 and 2005 March Current
Population SurveyOhio 1998 and 2004 Ohio
Family Health Survey
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A Brief History of Childrens Health Insurance
Expansions

• In 1965, Medicaid program enacted as part of the
  Social Security Act
• In late 1980s, Medicaid was expanded to poverty
  related infants and children through a series of
  legislative expansions
• In 1997, SCHIP authorized as part of the Balanced
  Budget Act

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Medicaid and SCHIP Gave States The Opportunity to
Greatly Reduce Uninsured Rates Among Children
10.7 million uninsured children in 1997
Source March 1998 Current Population Survey
calculations by The Urban Institute and Center
for Children and Families
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SCHIP Implementation Increased the Policy Focus
on Uninsured Children

• All states implemented a SCHIP program
• Streamlined eligibility determination process
• Unprecedented levels of outreach for Medicaid and
  SCHIP

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Ohios SCHIP ExpansionsCHIP I January 1998
all kids to 150 FPL
Eligibility For Children
of Federal Poverty level
Age 0-5
Age 6-14
Age 15-18
January 1998
December 1997
1999 State SCHIP Report, March 2000
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Ohios SCHIP ExpansionsCHIP II July 2000 all
kids to 200 FPL
Eligibility For Children
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Ohios SCHIP enrollment trends1998-2006
Feb-06
Source ODJFS, OFS, Bureau of Budget Management
Analysis
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SCHIP Sits on Top of the Medicaid Program
SCHIP Separate Program
SCHIP Eligible
SCHIP Medicaid Expansion
Medicaid Eligible
Medicaid
Source 2005 March Current Population Survey and
2003 Administrative Data Calculations by The
Urban Institute and Center for Children and
Families
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Who are the Uninsured Children of Today?
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Uninsured Children by Medicaid/SCHIP Eligibility
Source March 2005 Current Population Survey
Calculations by The Urban Institute and Center
for Children and Families
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Uninsured Children by Ethnicity
Source 2004 Ohio Family Health Survey special
analysis on children's data by Health Policy
Institute of Ohio
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Uninsured Children by Ethnicity
Source March 2005 Current Population Survey
Calculations by The Urban Institute and Center
for Children and Families
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Uninsured Children by Parental Work Status
Source 2004 Ohio Family Health Survey special
analysis on children's data by Health Policy
Institute of Ohio
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Uninsured Children by Parental Work Status
Source March 2005 Current Population Survey
calculations by The Urban Institute and Center
for Children and Families
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Coverage of Children Improves Access to Care
Source 1997 National Survey of Americas
Families Calculations by The Urban Institute and
Center for Children and Families Statistically
different from Medicaid at the 0.05 level using
multivariate analyses.
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Knowledge Gaps Among Low-Income Parents with
Uninsured Children, 2002
Heard of Programs but Not Aware Child Can
Participate Without Receiving Welfare
Haven't Heard of Medicaid or SCHIP
Heard of Programs and Aware Child Can Participate
Without Receiving Welfare
Source Kenney, Haley and Tebay (2003)
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Making the Case for Covering Parents Too
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Uninsured Rate for Ohios Adults Continues to Grow
Source 1998 and 2004 Ohio Family Health Survey
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Closing the Gap for Ohios Children and Families

• THREE-PRONGED STRATEGY
• Enroll and retain more of the uninsured but
  eligible
• Simplify enrollment and renewal processes
• Expand coverage

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Enroll and Retain

• Invest public dollars in community-based
  outreach, enrollment, and renewal activities
• Strengthen partnership with MCPs by providing
  renewal dates
• Outstation eligibility workers at FQHCs and other
  large Medicaid providers
• Set and monitor target rates by county

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Simplify Enrollment and Renewal Processes

• Presumptive eligibility for children
• 12-month redetermination for parents
• Electronic verification of income
• Strengthen ex parte review

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Expand Coverage

• OPTIONS/PROPOSALS
• Pregnant Women from 150 to 200 FPL
• Children to 300 FPL
• Parents/Adults, Ohio Healthy Workers
• Reauthorization of SCHIP in 2007

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