Health News
Leaders, from Illinois and across the country, are calling on Congress to continue funding the Children?s Health Insurance Program by highlighting its success in reducing the number of uninsured children and warning that these children may lose coverage or receive less age-appropriate care. The Children?s Health Insurance Program, or CHIP for short, offers developmentally appropriate healthcare for low-and-moderate-income children from families earning wages above the Medicaid threshold. In Illinois, the program covers 219,000 children and pregnant women as of June 30, 2014.
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Health News
Don't Chip Away CHIP
Leaders, from Illinois and across the country, are calling on Congress to continue funding the Children?s Health Insurance Program by highlighting its success in reducing the number of uninsured children and warning that these children may lose coverage or receive less age-appropriate care. The Children?s Health Insurance Program, or CHIP for short, offers developmentally appropriate healthcare for low-and-moderate-income children from families earning wages above the Medicaid threshold. In Illinois, the program covers 219,000 children and pregnant women as of June 30, 2014. The healthcare reform law funded CHIP until October 2015, but states need quick federal action as they plan their budgets for the coming year. Unfortunately, Congress may forgo CHIP funding, because children could potentially obtain health insurance through the health insurance marketplace. However, the health benefits in a marketplace plan may not equal those offered through CHIP, and families may not be able to afford the premiums and co-payments.
CHIP?s Benefits are Better
The essential health benefits in the marketplace?s qualified health plans can differ from CHIP?s; marketplace plans can either enact more stringent benefit limits or not cover important pediatric services. For example, a Government Accountability Office study of CHIP programs in five states including Illinois found that marketplace plans were more likely to limit pediatric services and that CHIP offered more generous ceilings for certain services.
Of special significance for children, marketplace plans are not required to cover pediatric dental services if a stand-alone dental plan is available. This means families might be forced to purchase a dental plan in addition to a general health plan for their children?increasing monthly premiums. Since the individual mandate would not apply to dental coverage, families may forgo pediatric dental coverage altogether.
Children in the Illinois CHIP program, All Kids, benefit from Early and Periodic Screening, Diagnosis, and Treatment services. EPSDT can identify medical conditions at an earlier and more treatable point in time and link children with necessary care. The benchmark plan for the state does not offer a comparable set of services.
Higher Costs and Family Glitches
CHIP health plans, including Illinois? All Kids, have better cost sharing arrangements than marketplace plans. Monthly premiums in All Kids range from $0-40, while the marketplace?s lowest cost bronze plan in Chicago had a heftier premium of $76 per month.
A report by the nonpartisan Medicaid and CHIP Access Payment Commission found similar patterns across the nation. According to the report, the actuarial value, or the costs covered by a health insurance plan, is generally lower in marketplace plans.
Parents and children forced out of CHIP plans would also encounter higher healthcare prices due to the ACA?s family glitch. The healthcare law bases affordable workplace insurance?and a family?s eligibility for marketplace financial assistance?on the cost of insuring individuals, not families. Parents are placed in the bind of being unable to afford their employer?s family plan, because that option involves much higher costs, but cannot qualify for tax credits or subsidies.
Stick with CHIP
Advocacy groups and leaders from both political parties have called CHIP a success. Since its creation in 1997, the program has increased the number of children with health insurance: 8 million children were enrolled in 2012 alone. The program has contributed to the marked decrease in the percentage of uninsured children, which has fallen from 13.9% to 7.1% over the past 17 years. Because of CHIP?s proven track record and uncertainty surrounding healthcare options in a post-CHIP era, Congress needs to continue funding this important program.
Bryce Marable, MSW
Policy Analyst
Health & Disability Advocates
Bryce Marable, MSW
Policy Analyst
Health & Disability Advocates
- Flexibility Act Would Give States More Medicaid Authority, But It Could Mean That Fewer Children Would Have Health Coverage
MEDICAID PERCENTAGE OF TOTAL STATE SPENDING?Children's advocates are concerned the proposed State Flexibility Act would result in more children living without health insurance in Kentucky. The act "would repeal protections put in place for states...
- More Kentucky Children Are Insured Under Kchip, Medicaid; Groups Commend Effort, Ask For Improvements
In the two years since the national Children's Health Insurance Program was reauthorized, about 51,700 children have been enrolled in Kentucky CHIP and Medicaid. Three advocacy groups -- Covering Kentucky Kids and Families, Kentucky Youth Advocates...
- How The Affordable Care Act Helps Immigrants
There are at least 40 million immigrants in the United States, accounting for about 13% of our country?s total population. The Affordable Care Act (ACA, also known as ObamaCare) helps immigrants by providing new and strengthening current health insurance...
- Illinois Essential Health Benefits Benchmark Plan
The State of Illinois has selected its Essential Health Benefits benchmark plan - the Blue Cross Blue Shield of Illinois BlueAdvantage Entrepreneur plan. This plan sets the bar for 10 categories of health care benefits (called "Essential Health Benefits"...
- Starting July 1 In Illinois: "some" Kids Instead Of "all Kids"
In 2010, a study conducted by the University of Illinois at Chicago showed that over 95% of Illinois? kids had insurance coverage, making Illinois a state with one of the lowest rates of uninsured children in the nation. Much of this success can be attributed...