SCHIP: States Looking Forward to Reauthorization

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Presentation transcript:

SCHIP: States Looking Forward to Reauthorization Presentation to The Second National Medicaid Congress June 15, 2007 Michelle Mickey, PeachCare for Kids Program Director Track4.01--Mickey--6.15@12.15pm MC

PeachCare Overview PeachCare for KidsTM is a comprehensive health care program serving over 280,000 children (May 2007) Covers uninsured children up to 235% FPL ($47,000 for a family of 4) No cost for children age 5 and under Monthly premiums range from $10 to $35 per child and no more than $70 per family Families who fail to pay premiums are locked out of the program for 1 month (note: during enrollment freeze, locked out until enrollment re-opens)

Program Design Separate SCHIP program – “Medicaid Look Alike” Shares managed care delivery system with Medicaid TPA handles eligibility, enrollment, client services & premium collection Families can apply via mail, online or phone Web site is also used to manage accounts and pay premiums (www.peachcare.org)

Who Does PeachCare Cover?

Overview of Federal Funds Allotment and Projected Deficit (in millions as of March 2007 SFY Allotment Prior Year Roll-Forward Federal Expenditures State Fiscal Year Deficit (Projected) Federal Fiscal Year SFY 04 $103.9 $241.0 $199.4 -0- SFY 05 $130.9 $168.2 $196.6 SFY 06 $129.5 $102.4 $142.9 SFY 07 $165.9 $ 89.0 $312.7 $ (57.8) ($131.2) SFY 08 n/a $337.1 $(171.2) ($171.7)

PeachCare for Kids: Federal Funding Shortfall Federal Match Rate = 73.3% FFY2007 Projected Expense = $450.4 million Federal Fund Deficit = $114 million (as of 5/07) Why? – population growth, decline in employer-sponsored insurance, flawed federal funding formula Closed enrollment March 31, 2007 and received temporary loan of state funds

Reauthorization: What States Want Immediately address needs of shortfall states Timely reauthorization Adequate and stable federal funding Sufficient to maintain current caseloads, and To make more progress covering uninsured children Predictable levels of funding critical to state planning

Reauthorization: Time for a New Formula Maintenance of effort to take into account children being covered. Ensure a more accurate count of the uninsured and low-income individuals Explore potential for more relevant measure of the “cost factor” Update allotments regularly

Reauthorization: What States Want “Preserve and strengthen opportunities for state innovation” Retain state flexibilities in program design, administration, benefits and delivery systems Facilitate the merging of public & private insurance by making it easier for states to subsidize employer-sponsored insurance Options allow states to adjust as the climates and markets they operate in change

Reauthorization: What States Want Don’t forget Medicaid! Funding for SCHIP should not sacrifice Medicaid funding Remove inconsistencies that make it difficult for families to move between programs Minimize mandatory administrative burdens – admin budget already limited Promote state-federal partnership to continue SCHIP’s demonstrated success