Children

1
Childrens Coverage On the Move
2
Childrens CoverageOn the Move

• Cindy Mann, Executive Director
• Center for Children and Families
• Georgetown University Health Policy Institute
• www.ccfgeorgetown.edu
• crm32_at_georgetown.edu
• Grantmakers for Health
• and
• Grantmakers for Children Youth Families
• April 24, 2007

3
The Value of Health Coverage
4
The Importance of Health Coverage for Children

• Children need proper physical and mental health
  to grow and develop to their full potential.
• Studies show that compared to uninsured children,
  insured children
• Have better access to a usual source of care
• Are more likely to receive needed care and
• Have fewer unmet health care needs.
• Insurance coverage can prevent unnecessary
  hospitalizations and emergency room use by
  providing timely and appropriate care.
• Health coverage can affect many aspects of a
  childs life.

5
Medicaid Supports Working Families

• Kevin Hall has severe allergic asthma
• 13 medications a day
• Visiting nurse
• New (expensive) treatment

Kevins mother had coverage from her job, but
unaffordable cost sharing and uncovered
treatments. Medicaid coverage has given Kevin
back his life and let his mother hold on to her
job.
6
Medicaids Role For Children with Special Health
Care Needs

• Brandie Haughey was adopted from foster care
• Multiple medical and developmental
  problems
• Weighs 55 pounds
• Requires medications for epilepsy, intensive
  speech and physical therapy, and ongoing
  monitoring for lesions.

Brandie wont be cured but now her seizures are
under control. She can use scissors, ride a bike,
color within lines, and her gait, speech, and
physical strength are improving.
7
Why Medicaid Matters to Rhode Island
Source The Poverty Institute at the RI College
School of Social Work, Why Medicaid Matters to
Rhode Island, 2006. http//www.povertyinstitute.or
g/matriarch/documents/PI_medicaid_finalweb28129.
pdf
8
Progress to Date
9
Childrens Eligibility for Medicaid/SCHIP, as
Implemented April 2007
NH
VT
ME
WA
ND
MT
MN
MA
OR
NY
ID
WI
SD
RI
MI
CT
WY
PA
NJ
IA
OH
NE
IN
NV
DE
IL
WV
UT
VA
MD
CO
CA
MO
KS
KY
NC
DC
TN
SC
OK
AR
AZ
NM
GA
AL
MS
TX
LA
AK
FL
HI
gt 200 FPL (18 states)
lt 200 FPL (10 states)
200 FPL (22 states including DC)
Note The Federal Poverty Line (FPL) for a family
of three in 2007 is 34,340. Source Based on a
national survey conducted by the Center on Budget
and Policy Priorities for Kaiser Commission of
Medicaid and the Uninsured, 2006, updated by CCF.
10
Medicaid SCHIP are Reaching an Increasing Share
of Eligible Children
1997 1999 2002
1999 2002
SCHIP
Medicaid
Source 1999 2002 National Survey of Americas
Families.
10
11
Trends in the Uninsured Rate of Low-Income
Children, 1997- 2005
Source CCF analysis of National Health Interview
Survey.
12
What Are the Key Issues in SCHIP Reauthorization?
13
SCHIP Spending is Rapidly Outpacing New Funds
Being Made Available
(in billions)
Source 1998-2007 data from Chris Peterson. SCHIP
Original Allotments Funding Formula Issues and
Options. Congressional Research Service (October
2006) 2007-2012 spending data from CBO March
2007 SCHIP baseline (February 2007) includes
outlays plus additional SCHP spending required to
maintain current programs.
14
Key Issues in Reauthorization

• Financing How much funds will be available, how
  they be distributed, and how will new SCHIP
  funding be paid for?
• Who can be covered?
• What kind of coverage will be provided and how
  can quality care for all children be assured?
• Is there more the federal government can do to
  help states reach and retain eligible, uninsured
  children?

15
States are Moving Forward
16
States Are Improving Childrens Coverage
NH
VT
ME
WA
MT
ND
MN
MA
OR
NY
ID
WI
SD
RI
MI
CT
WY
PA
NJ
IA
OH
NE
IN
NV
DE
IL
WV
VA
UT
MD
CO
CA
MO
KS
KY
NC
DC
TN
SC
OK
AR
NM
AZ
GA
AL
MS
TX
LA
AK
FL
HI
Implemented or Recently Adopted Legislation to
Improve Childrens Coverage (11 states and DC)
Considering Significant Proposal to Improve
Childrens Coverage (18 states)
Source Review of state initiatives by the Center
for Children and Families, between January 2006
and April 15, 2007.
17
States are Looking to Enroll More Children Who
are Already Eligible but Still Uninsured

• Arizona proposal to increase state funding for
  outreach and to change state law to facilitate
  school-based outreach and enrollment.
• Colorado proposal to cover more uninsured
  children by 2010 through a SCHIP eligibility
  expansion and by implementing presumptive
  eligibility and 12-month continuous eligibility
  for children.
• New Hampshire proposal to add funding to enroll
  an additional 10,000 children who are eligible
  for coverage.

18
States are Looking to Raise SCHIP Income
Eligibility
    Current Proposed
AK 154 175
CA 250 300
CO 200 300
DC 200 300
FL 200 225
MN 275 300
MT 150 175
NY 250 400
    Current Proposed
ND 140 150
OH 200 300
OK 185 300
OR 185 200
RI 250 300
SC 150 200
WA 250 300
WI 185 300
New York recently approved a budget
reflecting the expanded eligibility levels and
Washington has already signed legislation
expanding eligibility. Note Alaskas current
eligibility level is frozen at 175 of the 2003
FPL, which approximates 154 of the 2007 FPL, and
Minnesota covers infants up to 280 FPL.
Source CCF, Childrens Health Coverage
States Moving Forward (May 2007).
19
Key Questions Going Forward

• How will SCHIP reauthorization affect state
  activity?
• How can the current momentum be supported and
  strengthened?
• What are the implications of broader coverage
  proposals and initiatives?
• In light of the progress achieved and current
  interest in covering children, is this the time
  to get to the finish line?