A new bill gets passed, but some are worried about how much success could depend on tobacco taxes ‐MM Staff The State Children Health Insurance Program (SCHIP) Reauthorization Act of 2009 was signed in February, and will hopefully put an end to the rollercoaster ride that has been on since 2008. SCHIP was initially funded for 10 years, but the clock struck midnight in 2008. Last year was a nail‐biter in Medicaid agencies across the country, with funding on a month‐to‐month basis, with each continuing resolution offering only a short breather before the scramble for funds started up again. The new legislation doesn’t just hit the reset button on the original program. The bill takes CHIP to new homes across America. In addition to re‐authorizing coverage for the 7M kids covered under SCHIP nationwide, the bill offers potential expansion of coverage to 4M more kids if states opt in to the new federal rules. 1 The new package also offers a stable dental program under CHIP for the first time, as well as funding for quality measurement. 2 , 3 Early criticism centers on the funding mechanism for much of the reauthorization – increased tobacco taxes. Angry smokers are no surprise, but some analysts are concerned that balancing the future of such a vital program on the back of a vice tax during a recession may not be the brightest idea. States across the country are combing the expansion and tobacco tax opportunities. See below for more state by state info:
Arizona Arizona was actually ahead of the fund‐ the‐kids‐with‐cigarette‐money game (and it’s not just for healthcare). The tax increase was approved by voters in 2006 (80 cents per pack) and provided $236M in 2008. Even more tobacco dollars will be used to help provide health care and literacy program for kids in Arizona this year. Regional councils get to decide what $ the First Things First program funds. 4 Arkansas The Arkansas senate just upped the FPL eligibility for ARKids from 200% to 250% (the bill passed 82 to 14). The new rules will allow 8,000 more kids into the program. Arkansas’ expansion will be financed by an $86M increase in state tobacco tax going into effect March 09. 5 California CA CHIP will get 1.5B$ in funding from the reauthorization package in 2009 alone. There are currently 900,000 kids in CA CHIP now, and the rolls are growing by 30,000 kids a month. The federal match for CA went from $800M to $1.5B this year. 6 Kentucky KCHIP is considering expanding coverage to 12,000 more kids even n the face of struggling to provide services for the 54,000 kids it already covers. It is estimated that 120,000 kids are eligible, 1
making current enrollment less than 50% of the possible pool of kids even before the expansion. 7 Nebraska Nebraska is also looking to expand CHIP coverage after the reauthorization bill. There’s a lot of room for improvement – Nebraska currently caps family income at 185% of FPL, which only 6 states are that low or lower. Iowa covers kids up to 300% FPL. Legislative Bill 126 would raise FPL eligibility for Kids Connection (the Neb CHIP) to 200%. A similar bill was put up by the same sponsor last year but it died. It may be possible this year with Obama's reauthorization bill. 200% of FPL In 2009 is $44,100 for a family of four. An estimated 5,400 more kids could be covered with the change in the eligibility rules. 23,000 kids are currently covered in Kids Connection. 8 Utah Even as Utah faces a deficit this year, some legislators are moving to eliminate the five year waiting period for documented immigrant kids to get CHIP coverage. According to estimates, removal of the waiting period would cost about $400,000 to cover as much as 1,300 documented immigrant children. Part of the CHIP bill signed by Obama in February allowed for the removal of restrictions such as these . 9
Medical News Today. Medicaid Health Plans Of America Applauds Passage Of SCHIP Legislation. 05 Feb 2009 Medical News Today. President Signs Bill Expanding Dental Care Coverage In Health Insurance Program For Low‐ Income Children. 09 Feb 2009
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Commonwealth Fund. Statement from Commonwealth Fund President Karen Davis on CHIP Bill Signing. February 4, 2009 4 The Arizona Republic . Strategy unveiled on how tobacco tax will help kids:'06 Ariz. initiative will provide $91 mil this year for child health, education. by Chelsea Schneider ‐ Feb. 12, 2009 5 Associated Press ‐ Texarkana Gazette .Arkansas House OKs expansion of children’s health insurance03/10/2009 6
Medical News Today. CMA Praises SCHIP Signing, Calls On State Lawmakers To Cover Kids By Matching Federal Commitment. 09 Feb 2009 7 The Courier‐Journal. Ky. mulls insuring even more children. By Deborah Yetter .February 21, 2009 8 WORLD‐HERALD BUREAU, Nebraska Legislature: LB 136 seeks health coverage for more low‐income kids. BY MARTHA STODDARD. Published Monday February 16, 2009 9 Medical News Today. Two Utah Bills Seek To Lift Restrictions On CHIP, Medicaid Coverage For Documented Immigrant Children. 27 Feb 2009