COVERING KIDS: A STATE AND NATIONAL OVERVIEW
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COVERING KIDS: A STATE AND NATIONAL OVERVIEW Catherine A. Hess Senior Program Director National Academy for State Health Policy
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COVERING KIDS: A STATE AND NATIONAL OVERVIEW. Catherine A. Hess Senior Program Director National Academy for State Health Policy. Non-partisan non-profit dedicated to helping states achieve excellence in health policy & practice. - PowerPoint PPT Presentation
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COVERING KIDS: A STATE AND NATIONAL OVERVIEW
Catherine A. HessSenior Program DirectorNational Academy for State Health Policy
NASHP@January, 2007
Non-partisan non-profit dedicated to helping states achieve excellence in health policy & practice.
Conduct policy analysis and research,
interactive forums and assistance for executive & legislative branch state policymakers/administrators Conference Oct 14-16, Denver
Offices in Portland, ME & DC
NASHP@January, 2007
Child health specific coverage work support from Packard, Atlantic Philanthropies, Kellogg and RWJ
10 years supporting and reporting on state SCHIP implementation, now strong focus on reauthorization
Newer and growing focus on covering all kids
NASHP@January, 2007
Then and Now- A Success Story
In 1997, 23 % of low income children were uninsured
In 2004, 15% were uninsured, a drop of about one-third
NASHP@January, 2007
Ingredients of State Success : #1
Seven Steps, drawn from state and national policy experts
#1 Keep enrollment and renewal procedures simple, especially
12 month continuous eligibility Administrative (passive) renewals
NASHP@January, 2007
NASHP@January, 2007
Seven Steps for State Success : #2
#2 Community- Based Efforts Are Key to Enrollment
CA Children’s Health Initiatives evaluations- coordinated CBO work
MA experience- churning when CBO outreach cut
IL pays CBOs for each application leading to a new member
NASHP@January, 2007
Seven Steps for State Success : #3
#3 Use technology-coordinate programs, reduce admin. burdens
CA Express Lane MA Virtual Gateway PA Compass AL ADI UT Clicks
NASHP@January, 2007
Seven Steps for State Success : #4
#4 Change Agency Culture
Make goals clear Change language Provide training Provide tools and create systems
NASHP@January, 2007
Seven Steps for State Success : #5
#5 Engage Leaders Who Can Articulate a Clear Vision
Governors Kids popular, relatively inexpensive
Community Leaders
NASHP@January, 2007
Seven Steps for State Success : #6
#6 Engage partners, e.g.
Schools- incentives in federal nutrition and education programs
Managed Care Organizations- bottom line interest
Philanthropy- local and state foundations can help with research, planning, marketing
NASHP@January, 2007
Seven Steps for State Success : #7
#7 Marketing Is Essential
To policymakers To public To eligible families
NASHP@January, 2007
Much more to be done!
9 million kids uninsured Kids’ uninsurance rose in 2005 6% (MA) to 20%+(TX) Higher rates among adolescents, racial
and ethnic minorities > need targeting? 3 out 4 eligible for Medicaid/SCHIP 96% are citizens
NASHP@January, 2007
Growing Number of States Aiming to Go All the Way
NASHP@January, 2007
Getting to All: Some Challenges Identified By States
Complexity of multiple programs Marketing, outreach and enrollment:
How to target/what works? “All kids” message counters stigma
around enrolling in public programs Citizenship documentation negative
impact on simplified eligibility/enrollment
Non-citizen children
NASHP@January, 2007
Getting to All: Some Challenges Identified By States
Crowd-out/ go-bare periods Medical provider payments Insurer concerns: adverse selection What is “all”? 95%? Benefit packages- Tension b/t
Medicaid & Commercial Sustainability – SCHIP uncertainties
NASHP@January, 2007
Top 3 Issues in SCHIP reauthorization
1. Money2. Money3. Money $13- 15B needed over 5 years to
maintain current enrollment levels If frozen at $5B baseline, 36 states
might have shortfalls by 2012 “Pay go” rules require offset; fear
that this could come from Medicaid
NASHP@January, 2007
If SCHIP funded at baseline of $5B/Yr
NASHP@January, 2007
Other potential reauthorization issues
Formula and redistribution Populations covered Access to Quality Care/Performance Premium assistance/wrapping around
limited private plans/ESI interface State employee coverage Medicaid interface Citizenship documentation PERM
NASHP@January, 2007
Reauthorization timetable/prospects
????
President’s budget out February 5 – will play a role in setting the stage
Clock runs out on ‘07 shortfall temporary fix on May 4 (not all states may make it)
Budget resolution should be April 15
Clock runs out Sept. 30 on current law
NASHP@January, 2007
Summary
SCHIP has been successful in increasing public coverage (SCHIP and Medicaid financed) of kids in time of declining ESI
States have learned a lot about how to structure programs, work with partners, and get and keep kids enrolled
Growing number of states are aiming to cover all kids, taking on more challenges
Successful SCHIP reauthorization is critical to maintaining and making further progress in states in covering kids
NASHP@January, 2007
NASHP CONTACTS/RESOURCES
Catherine HessSenior Program [email protected]
John McInerneyProgram [email protected]
Alan WeilExecutive Director [email protected]
National Academy for State Health Policywww.nashp.org
Chip Centralwww.chipcentral.org
