1. SCHIP: States Looking Forward to Reauthorization
Presentation to
The Second National Medicaid Congress
June 15, 2007
Michelle Mickey, PeachCare for Kids Program Director MC

2. 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)

3. 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 (

4. Who Does PeachCare Cover?

5. 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)

6. 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

7. 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

8. 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

9. 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

10. 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