Yes We Can. . . Cover 4 Million Uninsured Children

Jennifer Sullivan, MHSSenior Health Policy Analyst

Families USA202-628-3030

jsullivan@familiesusa.org

Families USA – Health Action ConferenceJanuary 29, 2009

Key Questions

• How much longer until CHIP is reauthorized?

• What’s in the bill?

• What does it mean for my state?

Background

Hi, I’m new here.

What is CHIP?

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

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

Who Does It Cover?

Newly eligible,

17% (700,000 children)

Currently eligible, 83% (3.4 million

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.

Total: 4.1 million uninsured children

Financing

5.095.45

6.04

4.24 4.25 4.25 4.25

3.12 3.18 3.18

4.08 4.08

5.04

0.12

0.92

1.93

2.67

3.78

4.284.64

0

1

2

3

4

5

6

7

1998 1999 2000 2001 2002 2003 2004 2005 2006 2007

Allotment Expenditures

$ (B

illi

on

s)

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

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

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

Getting more children enrolled

Express Lane Eligibility $100 million in outreach grants

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

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

What does CHIP Reauthorization mean for states?

What does CHIP Reauthorization mean for states?

Stable funding through 2013, but . . .

Use it or lose it.

Are states ready to move forward?

States with projected budget deficits in FY2009 or FY2010

Alaska: noHawaii: yes

Source: Center on Budget & Policy Priorities, January 14, 2009

What Should I Do When the CHIP bill is signed?

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

Other issues to think about

Does my state use CHIP funds to cover parents?

Does my state use CHIP funds to cover other adults?

More information

Families USA

www.familiesusa.org

Stand Up for Health Care

www.standupforhealthcare.org