Families USA Health Action 2008 Covering Kids in Tenuous Times How Georgia Coped with Federal Funding Shortfalls in 2007 Tim Sweeney, Georgia Budget and Policy Institute
Tenuous Times in Many Ways SCHIP federal funding shortfall Limited state resources Political climate in Georgia hostile to public healthcare programs
PeachCare Background Separate program Covers kids up to 235% FPL Monthly premiums, no co-pays –$0 for kids under 6 –$10 to $35 per child, family max $20 to $70
Georgias Federal Shortfall PeachCare is the 4 th largest SCHIP program (NY, CA, TX) –Beginning FY 07 enrollment >250,000 FFY 07 allotment: $165.9 M FFY 07 federal funds spent: $340 M
Used with the permission of the GA Department of Community Health
As Shortfall Loomed, PeachCare Dominated Session State pressured Fed. Govt. for funds Advocates pressured Governor to use state funds Legislature took break hoping for federal solution, introduced cuts
GA Speakers Proposal Reduce eligibility to 200% FPL –Allow agency to adjust between 185%-225% Benchmark coverage against state employee plan Carve out dental and vision benefits and charge additional premiums
Senate Substitute Plan Eligibility changes: –Under 125% FPL moved to Medicaid –Lower PeachCare eligibility to 200% FPL –New program for 200%-250% FPL (member premiums of 5% of family income, no federal or state funds) Increase monthly premiums to 1.5% family income, add $25 ER co-pay (non-emer.) Retain basic dental, premium for comp. coverage
So – What happened? PeachCare enrollment frozen in March –Re-opened in July with cap of 295,000 State funds used to sustain program No Legislative Action… for now. Citizenship and income verification Significant enrollment declines since April 2007
PeachCare Enrollment Declines Enrollment Freeze March 11, 2007 Enrollment Reopened July 2007
Our Good News August directive does not affect Georgia State estimates $325 M in fed funds available in FY 2008 –Would allow additional 40,000 kids to enroll (to reach current 295,000 child cap) PeachCare to resume outreach activities
Georgia Budget and Policy Institute Tim Sweeney, Senior Health Care Analyst 100 Edgewood Avenue, Suite 950 Atlanta, Georgia