Children’s Health Coverage Observations from Louisiana
Children’s Health Coverage—A PrimerLuncheon Briefing
Alliance for Health ReformKaiser Commission on Medicaid & the Uninsured
Washington, DCFebruary 2, 2009
J. Ruth KennedyLa. Dept of Health & Hospitals
Lessons From Our Decade of Increasing Coverage for Children
Focus equally on Medicaid and SCHIP Administrative simplification matters Retaining eligible children at renewal is
essential Needs differ in 2009 than in 1997 Covering (virtually) all kids is achievable
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Children’s Health Coverage in Louisiana a Decade Ago
High rate of poverty and poor health outcomes
Absolute minimum levels of coverage for children
Onerous application and verification requirements
Nation’s third highest percentage of uninsured kids
Almost 1 in 3 low income children had no health coverage
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“A Rising Tide Lifts All Boats” —John F. Kennedy
Streamlining/SimplifyingSCHIP Eligibility & Enrollment Policies
Streamlining/SimplifyingMedicaid Eligibility & Enrollment Policies for Children
Most Louisiana Children in Public Coverage Are Enrolled in Medicaid
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Many Still Uninsured Kids Live Below Poverty Level
Literacy issues Parental priorities—Maslow’s
hierarchy of needs “Simplicity” of enrollment is
relative High mobility and lack of long
term attachments
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Highest percentage of La uninsured low income children: 50 to 100% of FPL
The Case for Administrative Simplification
Essential to enroll and retain most vulnerable children
Possible to achieve without compromising program integrity
Accelerates enrollment—access to care for eligible children
Positive administrative impact for cash strapped states
Advances in technology present new opportunities
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What Difference Does “Fixing” Renewals Make?
10,425 SCHIP Kids—Couldn’t renew 90 34,214 Medicaid Kids—Couldn’t renew 303 44,639 Total Kids—Couldn’t renew 393
393<1%
(2008 Rate)
August 2008
22%(2001 Rate)
9,822
Unexpected Roadblock in La on the Road to 300%
SCHIP reauthorization philosophical debate
CMS “August 17th” letter set new conditions for expansion 95% of kids <200% already
covered Five year ESI trend for kids
in state La expansion currently at
250%
The New “Hole in the Bucket”
Modest raises are putting families >200% FPL
Children moving from SCHIP or Medicaid coverage to uninsured
85% of enrollees in new LaCHIP Affordable Plan Received Medicaid or LaCHIP in last 36 months Did not voluntarily drop ESI in last 12 months
Increasing income limits will be essential to maintain gains
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We Can See Light at the End of the Tunnel
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Children with public coverage in La have more than doubled since 1999
State survey by LSU indicates uninsured rate for kids is 5.4%
“Culture” of eligibility has radically changed
Public and legislative support for children’s coverage
SCHIP reauthorization contains additional resources
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Ruth KennedyLaCHIP/Medicaid Eligibility Division DirectorLa Department of Health & Hospitals427 N 4th StBaton Rouge, LA 70802Telephone: 225 342 3032Fax: 225 342 9508Blackberry: 225 241-1437E-Mail: rkennedy @ dhh.la.gov www.lachip.org
Never doubt that a small group of thoughtful, caring people can change the world. Indeed, it is the only thing that ever has! — Dr. Margaret Mead
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