One of the most common questions we get at CCF is, "What are states doing to cover kids?" Since CHIP was reauthorized in February, this question has taken on a new twist: "Are states doing more to cover children since the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 was signed by President Obama?" The answer is an unequivocal, "Yes," which, given the current status of state budgets, may come as a surprise to many; it was to me.
Just last Friday, we heard the news that Florida, a state grappling with significant budget problems, passed legislation that would cut red tape and make it easier for families to get and keep their children enrolled in KidCare, Florida's CHIP program. In addition to Florida, there are other states including Iowa, New Jersey, and Texas, that have passed or are considering similar legislation that would take advantage of the opportunities in CHIPRA to reach the 70 percent of children who are eligible for, but unenrolled, in Medicaid or CHIP.
Across the country, states have passed new legislation, or are still considering new legislation, to offer affordable coverage to more children by increasing the income threshold for publicly-financed health coverage. Affordability, especially during these tough economic times, is the number one reason that families forgo or skimp on health care needs. A recent survey conducted by the Kaiser Family Foundation found that families are more concerned about how they will afford to pay medical bills than their mortgages.
These realities and help offered by CHIPRA have prompted leaders from Arkansas and Colorado to pass legislation expanding coverage. Other states, like Montana, are merely awaiting a Governor's signature to make their expansions a reality, while states such as Nebraska and Oregon are considering bills that would offer health coverage to even more families. In addition to these states, there are those like Kansas and Washington, who are fulfilling promises made in earlier sessions by implementing planned expansions.
While we don't know yet whether all of these possibilities will, in fact, become law, we can say that CHIP reauthorization has been a major catalyst for creating an environment where state policymakers are asking the question about whether or not now is the time to do more to get children covered and answering with a resounding, "Yes!"
A note: This is just a sampling of what we have learned in recent months and is by no means an exhaustive list of state activity in the aftermath of CHIPRA - a more comprehensive analysis will be available later this year from CCF about movement at the state level on children's coverage.
The Kaiser report you cited shows that the health care crisis is as bad if not worse than the housing meltdown. The healthcare system is just as complicated as the mortgage finance system and if political leaders at the federal and state level ignore this crisis, there will be an even greater mess than the financial crisis. We need more states to follow the lead of the states you mentioned in the short-term and health reform to follow.
We're considering a limited expansion here in NC, but as our budget problems are getting progressively worse (we are at least a billion more in the hole than we thought), we are going to have to really work to keep more coverage for kids in the budget.