Healthy Families gets slight reprieve

Seeing a slightly brighter financial picture on the horizon, the Managed Risk Medical Insurance Board on Thursday postponed for one month the process of kicking kids out of the Healthy Families program.

Disenrollment will begin with notices mailed to families on October 1, instead of September 1 as originally planned.

Board members and staff voiced hope that, somehow, more funds will surface to save them from having to follow through with the disenrollment plan, adopted by voice vote earlier this month.

Perhaps coincidentally, the 30-day reprieve came as the nation marked the death of Senator Edward Kennedy, an original author of the nationwide children’s health insurance program, or SCHIP, which in California is known as Healthy Families.

President Obama’s ARRA economic stimulus initiative called for an expansion of SCHIP, pledging beefed-up funding of $2 in federal matching funds for every $1 that states invest in the program.

While at least a dozen states have managed to use the added federal funds to grow their SCHIP programs to cover more children than ever, California’s stubborn budgetary problems due to the lingering recession has led to cutbacks — and less services for fewer children.

The final version of the state budget crafted by the Legislature and Governor Arnold Schwarzenegger targeted Healthy Families with $194 million in cuts.

That amounted to a substantial financial blow to the program for low-income, working, taxpaying families in California – those whose income is too high to qualify for Medi-Cal and too low to afford health insurance for their kids on the open market.

Still, the blow was softened greatly by an $81.4 million commitment from the voter-approved First Five Commission, which pitched in funds to cover about 200,000 children ages 0 to 5 for one year.

Childrens’ advocacy groups and coalitions such as Children Now, The 100% Campaign and the Children’s Health Initiative have been persistent in urging MRMIB to tread cautiously while implementing program cutbacks due to insufficient funds.

One advocate stood up from her seat in the MRMIB auditorium Thursday upon hearing the board discuss delaying disenrollment. Called on by a puzzled Chair Cliff Allensby, the advocate blurted out: Thanks. I just wanted to say ‘thanks.’’’

Meanwhile, the number of children whose names have been added to a waiting list for access to Healthy Families coverage has grown to 70,788, following a consistent trend of an 11 percent increase since the last count was released on August 20.

Most of the children seeking access to Healthy Families live in Southern California, the board’s staff reported, where population density necessitates greater services than elsewhere in the state. More than half of the children signed up on the waiting list reside in five Southern California counties.

A portion of the brighter financial picture for Healthy Families comes from higher fees to be paid by the families served. Generally, co-pays that were $5 for services will rise to $10 — or up to $15, in the case of paying for prescription name-brand drugs when a generic version is available.

Visits to the emergency room will result in a co-pay hike from $5 to $15 whenever hospitalization is not required.

Premiums for those families with incomes that are 150% to 200% of the federal poverty level will increase from a family maximum of $36 to $48.

Premiums for families earning from 200% to 250% of the federal poverty level will rise from a family maximum of $51 to $72.

The changes seem bound to remain in place even if more funding is found, something that staff told board members is almost certain to materialize through an anticipated “complicated array of solutions.” 

Stay tuned for more developments  ….
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