CHIPRA Led Way to More Stable and Accessible Coverage in Ohio – Say Ahhh! A Children’s Health Policy Blog

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(Editor’s Note: CHIPRA celebrates its second anniversary this week and Say Ahhh! is featuring guest blogs about how the law has impacted children and families in their states.  Mary Wachtel of Voices for Ohio’s Children is today’s featured blogger.  Ohio was also featured in CCF’s 50-state survey of Medicaid and CHIP eligibility and enrollment released by Kaiser last month and Mary joined CCF at the report release event.)

By Mary Wachtel, Voices for Ohio’s Children

Like others, I look forward every year to the release of
the Kaiser Commission on Medicaid and the Uninsured’s  annual 50-state survey of Medicaid and CHIP eligibility and
enrollment.  This year’s report,
“Holding Steady, Looking Ahead” – released in January — was especially
exciting because Ohio was cited for its fast implementation of two
simplification policies. 

As the report notes, (now former) Governor Strickland was
the first Governor to join the Connecting Kids to Coverage challenge.  He did that last March 10, at our Ohio
Covering Kids and Families conference. 
In addition to committing to enrolling all of Ohio’s uninsured eligible
kids within five years, he also committed to implementing presumptive
eligibility for children and pregnant women, 12-month continuous eligibility,
and express lane eligibility. 

Three weeks later, on April 1, presumptive eligibility
for children and 12-month continuous eligibility for children were
operational.  Accomplishing this in
three weeks is a huge deal and shows that government can move fast and
efficiently.  This aggressive
timeline was driven by the possibility of securing CHIPRA performance bonus
dollars.  We knew very clearly that
we had to hit an April 1 implementation date to qualify for the bonus and by
golly, that’s what happened.  That
paid off when Ohio was indeed awarded a CHIPRA performance bonus at the end of
December.  We are working hard to
make sure that at least some of those dollars support further simplification
efforts so more uninsured kids can gain and keep coverage.

Beyond the technical ins and outs of Medicaid
simplification, these policies matter greatly to families and to eligibility
workers.  Let me share a few observations
and thoughts.

Stability of coverage matters.  It’s not only about finding and enrolling children, it’s
about keeping eligible children enrolled, so they can get the preventive
services they need like developmental screenings, immunizations and well-child
visits.  So 12-month continuous
eligibility means that a working mom who gets a modest raise during the course
of the year no longer has to worry that her kids may lose their health
coverage.  While the majority of
kids in our state covered by Medicaid are now on the lower end of the income
scale, I’ve talked to parents who are near that 200%  FPL level and anticipate getting more hours or a raise, and
are faced with the possibility of losing health coverage for their kids as a
result.  Some actually consider
turning down the offer.  12-month
continuous eligibility takes away that perverse incentive – at least for the
year – and gives those families peace of mind that their kids won’t lose
coverage because of a positive opportunity at work. 

Cutting red tape helps eligibility workers better manage
growing caseloads
.  Ohio’s county Jobs and Family Services agencies, who determine eligibility for Medicaid and other public programs,
are overwhelmed.  Over the last
four years, they have sustained a 40% cut in funding, while many programs they
administer have seen increases in need of over 50%.  Statewide, they are operating with 3250 fewer staff than
just three years ago.

So clearly, streamlining and modernizing are key.  Now that families can renew their
eligibility via telephone, it takes less time and hassle for the family AND for
the eligibility worker.  12-month
eligibility means the caseworker touches the case only once during the year,
rather than the possibility of multiple times.

Of great interest for both the agencies and advocates in
Ohio is better use of data matching to verify information up front, rather than
asking families to produce paper. 
We are not nearly where we could or should be, but we are of one accord that
this is absolutely a next step we must take.

Finally, we can’t forget the very simple truth that it’s
about kids.
  Over and over, the
public has demonstrated strong support for kids’ health.  And behind all the statistics and
jargon are real people who do not see health care for their children through a
partisan lens.  They want to know
they can get health care even they lose a job, or when they have to try to
balance a family budget with less earnings, or when they get sick, or when
unemployment runs out. 

It’s about an unemployed dad in Cincinnati who has three kids and whose COBRA payment
consumes 74% of his monthly unemployment compensation.  He had no idea he and his kids are
eligible for Medicaid, but thanks to local outreach efforts, he now knows and
is getting help to apply.

It’s about a couple who are long-time small business
owners.  Last year after business
had shrunk, they could no longer pay for their family’s health insurance
policy, but they still have a son in school who likes to play sports.  So the mom found us, picked up the phone
and said, “I never thought I’d ask this, but how do I get my son on Medicaid?”

And it’s about a little six-year old girl with Down
Syndrome who was uninsured for nearly two years because her self-employed
father made too much to qualify for Medicaid and she couldn’t get affordable
health insurance because of her pre-existing condition.  Their family situation has changed and
Medicaid is now available for her. 
Her parents finally have peace of mind for their daughter.  

So yes, these policies matter to these Ohio families as
well as to countless others across the country.  Let’s redouble our efforts to make sure we  not just hold steady in 2011, but
continue to make progress. 

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