KCMU Reports Show Economy, Federal Rules May Hamper States’ Expansion of Health Care Coverage to Low-Income Children |
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Written by U.S. Insurance News
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Friday, 01 February 2008 |
Count one more group of people on whom the sluggish economy is taking a toll—low-income children without health care coverage.
Count one more group of people on whom the sluggish economy is taking a toll—low-income children without health care coverage.
The Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) has released several reports that indicate the once aggressive efforts by states to expand health care coverage to low-income children and their families may be curtailed as a result of the stalled U.S. economy and two other key factors: an extension (but not full reauthorization) of the State Children’s Health Insurance Program (SCHIP) and new federal rules affecting Medicaid and SCHIP eligibility.
This is the conclusion KCMU drew from a series of new studies it has conducted, including a nationwide survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in ten states representing all regions of the country, and an examination of enrollment in Medicaid and SCHIP.
“In the last recession, federal fiscal relief was critical to states’ ability to sustain Medicaid enrollment. Without additional federal assistance for Medicaid and SCHIP in this economic downturn, we are likely to see added growth in the uninsured,” explained Diane Rowland, executive director of the KCMU.
The seventh annual 50-state survey of eligibility rules, enrollment, and renewal procedures, as well as cost-sharing practices in Medicaid and SCHIP, shows that 32 states expanded access to their Medicaid and SCHIP programs between July 2006 and January 2008. However, without the reauthorization of the SCHIP program and with a new federal directive restricting states from using SCHIP to cover children in families earning more than 250 percent of the federal poverty level, these efforts could be curtailed. Twenty-three states could be affected by the directive, including 14 that have already implemented their plans and 10 that have authorized the plans into law but have not yet implemented them. (Washington is counted in both categories.) Three states have already cut back on their coverage.
States also report that the Medicaid citizenship documentation rule is hampering efforts to simplify enrollment and resulting in delays and denials of coverage.
KCMU also issued a report based on discussions held last November with ten leading Medicaid directors. They warned that with increasingly poor economic conditions, state Medicaid programs will be adversely affected. Virtually every state has already taken action to control costs on prescription drugs and provider payments. Further action in these areas would result in minimal additional savings and could impact access to care, according to the directors.
The directors also expressed concern over an increasing strain in their relationship with the federal government, as well as concern over federal rules on health coverage and services issued over the past year that will restrict federal Medicaid financing. These rules, the directors say, will adversely affect beneficiaries and safety net providers as they try to adjust to the economic downturn.
Each of the five reports issued by the KCMU is available at the Kaiser Family Foundation Web site.
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