Responses to The Affordable Care Act Sam Earl

Points We Will Consider Why is this issue important? What are we now? What criteria should we consider for our future path? What policy alternatives should we consider? Why I recommend that eligibility levels remain the same and that outreach efforts be increased. How will we evaluate our policy?

Why is this issue important? Negative economic consequences $15,572 for uninsured male $11,646 for uninsured female $41 Billion for uninsured patients Justice Children lack economic agency

Where are we now? CHIP and SCHIP have helped states provide health coverage for children since CHIP Medicaid Expansion provides coverage for children in families between 100% and 132% FPL FAMIS provides coverage for children in families between 133% and 200% of FPL 111,000 uninsured children in Commonwealth ACA provides matching funds to expand eligibility to 300% of FPL

What criteria should we consider? Percentage of Children covered by health insurance Health outcomes and access for low-income children Cost for the state government Cost for families Impact on private insurance companies

What policy alternatives were considered ? Keep eligibility at current levels Expand eligibility to include families earning less than 225% of FPL Maintain eligibility levels and increase outreach

Percentage of Uninsured Children (U.S. Census Bureau,2011)

Health Access (Laurie, 2009)

Criteria Alternatives Matrix Alternatives Criteria Keep Eligibility At Current Levels Expand Outreach Efforts Expand Eligibility to 225% of FPL Percentage of Children Covered 578 Health Outcomes Cost for Virginia 7 65 Cost for Families 76 5 Impact on Private Insurance 8 75

How should this policy be evaluated? Are we achieving better health outcomes not just increasing coverage? Are we balancing these health outcomes and costs? How are we affecting those covered by private plans? Do we need to increase co-pays?

Conclusion Children’s healthcare impacts all of us. CHIP has increased the percentage of children with insurance, but some are still without coverage. There are costs for Virginia regardless of the policy we choose. Maintaining current eligibility levels and expanding outreach is the best way forward.

Works Cited Davidoff, A., Kenney, G., & Dubay, L. (2005). Effects of the state children's health insurance program expansions on children with chronic health conditions. Pediatrics, 116(e34), Retrieved from html Department of Planning and Budget, (2010) fiscal impact statement. Retrieved from Department of Planning and Budget website: SB266F122 PDF Fox, M. H., Moore, J., Davis, R., & Heintzelman, R. (2003). Changes in reported health status and unmet need for children enrolling in the Kansas children's health insurance program. American Journal of Public Health, 93(4), Retrieved from Gruber, J., & Simon, K. (2008). Crowd-out ten years later: Have recent public insurance expansions crowded out private health insurance?. Journal of Health Economics, 27(2), Retrieved from James A. Baker III Institute for Public Policy of Rice University. The Economic Impact of Uninsured Children on America. (2009). Houston, TX: Author. Retrieved from HoShortUninsuredChildren pdfhttp:// HoShortUninsuredChildren pdf Lurie, I. (2009). Differential effect of the state children's health insurance program expansions by children's age. Health Services Research, 44(5p1), doi: /j x United States Census Bureau. Health Insurance Coverage Status and Type of Coverage - Children Under 18 by Age: 1999 to (2011). Washington D.C.: Author. Retrieved from Virginia Department of Medical Assistance Services, (2012). Report on the status of the virginia family access to medical insurance security plan trust fund. Retrieved from Virginia Department of Medical Assistance Services website: Year/RD /$file/RD352.pdf