The
Associated
Press
State
& Local Wire
April
8, 2003
By SUZANNE GAMBOA, Associated Press Writer
Insuring nearly all children is possible if states continue the
progress they've made covering low-income kids through existing
programs and make some changes in how they are financed, a
private foundation reported Tuesday.
Many states have managed to reduce the numbers of uninsured
children, said a report by the David and Lucile Packard
Foundation. But those successes are threatened as states face
budget crises and the federal government looks to control
spending. David Packard was co-founder of Hewlett-Packard Co.
About 1.6 million more children have gained coverage since 1998,
said Eugene Lewitt, the foundation's senior program manager. By
2001, Medicaid provided insurance to 21 million low income
children and the State Children's Health Insurance Program, or
SCHIP, covered 3.5 million, the foundation said.
Courtney Bennett, foundation policy analyst, said only four
states - Georgia, Indiana, New Hampshire and New Jersey - had
more than a 2 percent increase in uninsured children, during
1999 to 2001. In
Texas
, 21.5 percent of children under 19 were uninsured in 2001,
compared to 23 percent in 1999.
The information is based on the most recent data available in a
survey by the Center on Budget and Policy Priorities, a group
that focuses on how policies affect poor people.
"If state and federal governments don't act now to save
these programs" the increases in uninsured children will
extend beyond the four states, Bennett said.
An estimated 8.5 million children nationally lack health
insurance. About 76 percent of those children are eligible to
participate in SCHIP or Medicaid, she said.
In
Texas
, House budget writers have scaled back Medicaid and the
children's health insurance program to help deal with a $9.9
billion revenue shortfall. The action is expected to leave
hundreds of thousands of children without coverage.
"From the states' perspective, we are continuing to face
the worst crisis since the second World War," said Ray
Scheppach, National Governor's Association executive director.
At the federal level, the House made billions of dollars in cuts
to Medicaid and about $2 billion in the SCHIP program when it
passed its budget blueprint. The Senate passed a budget outline
with less drastic cuts, said Leighton Ku, health policy senior
fellow at the Center on Budget and Policy Priorities. The
differences are being worked out in committee with much of the
outcome dependent on the size of the tax cut Congress hammers
out.
In addition to budget troubles, the way Congress structured
SCHIP financing has created problems for states.
Congress created a $40 billion block grant for SCHIP to be
distributed over 10 years. But states don't get the same amount
every year, instead more money is released in the first four and
last three years. That means SCHIP money reduces by $1 billion
in the years 2002 to 2004, the Packard foundation report said.
"This decrease unfortunately coincides with an increased
need for SCHIP funds because of increasing enrollment," the
foundation said.
The foundation said between $4.6 billion and $6.1 billion in
unused federal matching money is available to cover uninsured
Medicaid- and SCHIP-eligible children, but most states are
unable to come up with state money - an estimated $2.7 billion
to $3.7 billion - to get the federal money.
Unused money expires and is returned to the Treasury. The
foundation recommended not allowing the money to expire. The
foundation suggested states be given more time to get the unused
money.
The Packard Foundation report recommends changing Medicaid and
SCHIP financing so that children can be covered in down times.
It also recommended raising the federal matching rate for
Medicaid to the SCHIP level to encourage states to enroll more
children in Medicaid and to simplify enrollment.
On the Net: The Future of Children report: http://www.futureofchildren.org/
National Governors Association: http://www.nga.org
Reuters
Report:
States Could Cover Most Uninsured Kids
Tue April 08, 2003
05:47 PM ET
By Todd Zwillich
WASHINGTON
(Reuters Health) - More aggressive use of existing of low-income
health programs could deliver medical coverage to 97 percent of
uninsured children in the
U.S.
, according to a report issued Tuesday.
Researchers
estimated that the government could provide health coverage to
most of the 8.5 million
U.S.
children who currently lack coverage by strongly promoting the
state children's health insurance programs (SCHIP) to parents
who don't know that their children are eligible.
Many
of those parents are recent immigrants who may avoid the
coverage because of language barriers or fears of having to
reimburse the government, the researchers said.
"Mostly
confusion or misinformation" is responsible for the gap in
coverage of eligible children under SCHIP and Medicaid, the
other major public health insurance program for low-income
children and adults, said Courtney Bennett, a policy analyst at
the David and Lucile Packard Foundation, which issued the
report.
Bennett
said that states should do more to inform low-income parents
about the availability of SCHIP and should also try to reduce
barriers to enrollment in the program.
The
foundation also wants states to consider covering children who
come from working families earning more than 300 percent the
federal poverty level, which includes approximately 5 percent of
uninsured children.
But
the call comes at a time of extreme budget austerity in nearly
all 50 states, where financial deficits are expected to run as
high as $80 billion next year. The deficits mean that few states
can afford to expand enrollment in their SCHIP plans, which
require states to share the cost of the program with the federal
government.
"States
will be hard-pressed to come up with the matching money,"
said Eugene Lewitt, a senior program director at the foundation.
Some
groups have called on Congress to release billions in unspent
SCHIP money that was returned to the federal treasury last year
and to temporarily increase the federal share of Medicaid
payments to the states.
Those
efforts, while favored by some in Congress, have met with
resistance. A Senate-passed bill to release $2.7 billion in
SCHIP money to states last year went unanswered in the House.
This year, the House passed a budget resolution calling for $93
billion in Medicaid cuts over the next decade.
The
resolution has yet to be reconciled with a Senate budget, which
does not call for the cuts.
Gannett
News Service
Tight
funds hurt health coverage
CHIP helps insure children, but
Missouri
plans to make cuts from the health program.
By Pamela Brogan
Washington
-- About 8.5 million of the nation's poorest children are not
covered by health insurance and another million could lose
coverage because states are struggling with tight budgets and
deficits, a report issued Tuesday concludes.
Despite
state and federal efforts to provide health coverage to poor
children under the Children's Health Insurance Program (CHIP),
the percentage of uninsured children rose in 10 states,
including
Missouri
, from 1999 to 2001, said a report by the David and Lucile
Packard Foundation, a nonprofit group.
In
Missouri
, the percentage of uninsured children rose from 3.7 percent in
1999 to 5.3 percent in 2001.
Missouri
's program provides coverage for about 84,000 children.
Nationwide,
CHIP provides health care coverage to 3.5 million children whose
families lack private insurance but earn too much to qualify for
Medicaid.
"Public
health insurance programs are currently threatened with less
funding at precisely the time when the need is increasing,"
said Lois Salisbury, director of the Children, Families and
Communities program at the foundation.
Georgia
showed the largest increase in the percentage of uninsured
children.
Louisiana
led states where the percentage of uninsured children dropped.
Nationally,
the number of uninsured children decreased slightly from 9.9
million in 1999 to 9.2 million in 2001.
But
with states projecting combined budget shortfalls of $80 billion
next year, deep cuts are expected in health programs for
children.
At
least five states --
Montana
,
Idaho
,
Illinois
,
New Hampshire
and
Massachusetts
-- have announced cuts in CHIP, according to a survey of 44
states by the National Conference of State Legislatures.
Missouri
is one of 11 states proposing cutbacks. The others are
Minnesota
,
Nebraska
,
Arizona
,
Texas
,
Louisiana
,
Alabama
,
Florida
,
South Carolina
,
Connecticut
and
Alaska
.
"Some
states, like
Missouri
and
Texas
, are really going to hurt kids," said Leighton Ku, a
policy analyst for the Washington-based Center on Budget and
Policy Priorities.
Texas
wants to cut 400,000 children from it. And earlier in the
legislative session,
Missouri
's House Appropriations Committee proposed eliminating the
program.
Gov.
Bob Holden has threatened to veto the
Missouri
bill if the cuts are approved by the state legislature.
Harold
Bengsch, director of the Springfield-Greene County Health
Department, said CHIP covers about 7,000 children in
Springfield
and
Greene
County
. He said cutting the insurance program would force poor
children to seek health care at emergency rooms, which is more
expensive for taxpayers. "It's preventive care that saves
money in the long term," he said.
Meanwhile,
a U.S. House budget plan proposes reducing the children's health
program by $2 billion over 10 years beginning in 2004.
"It
doesn't look good," Rep. Hilda Solis, D-Calif., who chairs
the Congressional Hispanic Caucus' Task Force on Health, said at
a news conference in
Washington
. "It looks like we are trying to reduce the safety net for
poor children and their families."
National
Journal's CongressDaily
April
08, 2003
Report Gives SCHIP Good Marks For Covering Uninsured Children
The State Children's Health Insurance Program got relatively
good marks for covering uninsured children in a report released
today by the David and Lucile Packard Foundation. But states'
fiscal crises may result in less funding to cover rising numbers
of children in the program. "SCHIP got off to a rough,
bumpy start, but it has been a major success," said Lois
Salisbury, the director of the Packard Foundation's Children,
Families and Communities Program. "States are now pressured
to cut programs, and progress is threatened."
Deficit-plagued states will find it difficult to come up with as
much as $3.7 billion in matching money in order to access the
$4.6 billion to $6.1 billion in unused federal funds, the study
said. The foundation released new state-by-state data analysis
showing that only four states have seen the number of uninsured
children rise by more than 2 percent. One "long-term"
solution the study suggests is funding SCHIP and Medicaid with
mechanisms similar to those used for unemployment insurance, in
which funding increases in times of economic downturn.
KAISER
DAILY HEALTH POLICY REPORT
A
service of kaisernetwork.org
http://www.kaisernetwork.org/dailyreports/healthpolicy
________________________________________
Tuesday, April 8, 2003
NEW
RELEASES
10.
The Latest Reports in Health Policy
Access
this story and related links online:
http://www.kaisernetwork.org/daily_reports/rep_index.cfm?DR_ID=17062
"Health
Insurance for Children," David and Lucile Packard
Foundation: The report, part of the foundation's The
Future of Children journal, states that with improved financing
structures and other changes, Medicaid and the CHIP program
could cover 97% of all low-income children within three to five
years. The foundation also released a survey conducted by
ICR/International Communications Research that shows 64% of
1,007 respondents believe that federal and state governments
should take steps to ensure public health programs do not face
budget cuts and that 79% of respondents said the federal
government should give states more financial help to insure all
children even if it means increases in taxes (David and Lucile
Packard Foundation release, 4/8). A Web cast of the
briefing to release the new data is available online at
kaisernetwork.org.
AHA
NEWS NOW
Tuesday,
April 8, 2003
Today's
headlines:
1.
Rural relief bill introduced in House and Senate
2.
Report, poll urge support for children's health insurance
programs
3.
HANYS: Proposed hospital-funding cuts would cost economy twice
as much
4.
GAO recommends developing bioterrorism preparedness benchmarks
5.
NEJM article examines SARS outbreak in
Hong Kong
hospital
2)
Report, poll urge support for children's health insurance
programs
An
estimated $4.6 billion to $6.1 billion in unused federal
matching funds is available to cover uninsured children through
Medicaid and the State Children's Health Insurance, but most
states will be hard-pressed to come up with the matching funds
needed to access the federal money due to intense pressure to
cut their budgets, according to new data and a report released
today by The David and Lucile Packard Foundation. The report
recommends state and federal governments increase funds for
Medicaid and SCHIP to meet the increased demand for public
health insurance during the economic downturn. It also
recommends the federal government raise the federal Medicaid
matching rate for children to the same level as the SCHIP
matching rate to encourage states to enroll more children in
Medicaid and simplify administration of both programs. The
report includes data indicating the Medicaid and SCHIP programs
continue to reduce the number of uninsured children, and
concludes that enrolling all eligible children in existing
public health insurance programs could provide coverage for
virtually all children. The foundation also released the results
of a new poll showing strong public support for these programs.
More than eight out of 10 respondents indicated the federal
government should provide states with extra help to provide all
children with health insurance, and more than six out of 10
strongly agreed the federal government and states should take
steps to protect the Medicaid and SCHIP programs from budget
cuts. For more on the report and poll, go to http://www.futureofchildren.org/.
