This week’s MRMIB decision…

Earlier this week, the Managed Risk Medical Insurance Board (MRMIB) made the unfortunate decision to adopt emergency regulations to govern the process of disenrolling children or putting children on waiting lists for coverage in the Healthy Families program, which is California’s version of the State Child Health Insurance Program.

Let’s be clear up front: these regulations do *not* mean that there’s a wait list for Healthy Families now. There was a real danger of that several months ago, when President Bush kept vetoing funding for the SCHIP program–but the immediate crisis passsed, with a package that allowed the program to continue (although not at the levels for needed additional enrollment) for the remainder of Bush’s term.

However, even though the immediate crisis has passed, MRMIB has continued with setting up the structure for a waiting list or disenrollment process. Many health care stakeholder groups urged MRMIB to step back and slow down, now that the immediate crisis had passed. Health Access California was pleased to be a signatory with 20 diverse organizations in opposing the regulations.

Yet earlier this week, MRMIB voted to adopt the regulations. MRMIB’s website has links to the regulations themselves, as well as to testimony by advocates, and MRMIB’s responses to the issues raised–which were both about the very premise of the regulations, as well as specific issues about the substance.

This was an unneeded action. I hesitated even writing this report because I didn’t want to contribute to the very problem that leads us to oppose the regulations in the first place: the potential confusion about the ability to enroll in the program, and even more so, an undermining of trust with those families enrolled, an undermining of the security which is the point of the coverage to begin with.

The biggest problem with these new regulations is that if there’s a budget shortfall, then it should be our elected leaders–the Governor, the Legislature–who make the tough calls about whether to start denying children health coverage, and if so, which ones should be denied first. MRMIB should be not be taking those decisions away from those most accountable–our elected representatives.

We understood that the appointed members of MRMIB felt responsible for the fiscal stewardship of the program, but they action made them too responsible–and took away responsibility from our elected leaders. If the moment comes when the money has really run out in the Healthy Families program, that’s where the decision should lay. So for many reasons, while these regulation are adopted, we need to be watching closely to make sure they are never used.

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