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Kids’ Health Insurance Coverage: Where are we now and how can we get all kids covered?. June 30, 2010 All Kids Covered Initiative www.allkidscoveredinitiative.org. Colorado All Kids Covered Initiative. History and evolution 2006 – Present Clear and enduring focus on

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kids health insurance coverage where are we now and how can we get all kids covered

Kids’ Health Insurance Coverage:Where are we now and how can we get all kids covered?

June 30, 2010

All Kids Covered Initiative

www.allkidscoveredinitiative.org

colorado all kids covered initiative
Colorado All Kids Covered Initiative
  • History and evolution
    • 2006 – Present
  • Clear and enduring focus on
    • Developing Sound Policy
    • Building Public Will
  • Supported by a infrastructure of a funded leadership team and a diverse membership

.

kids coverage in colorado
Kids Coverage in Colorado
  • Public coverage programs experiencing all time high levels of enrollment.
  • 2010 Update
    • 860,000 Privately Insured
    • 214,000 Public/Other
    • 176,000 Uninsured

Source: The Colorado Health Institute, Colorado Children’s Health Insurance Status: 2010 Update which analyzed the 2008 US Census Bureau American Community Survey.

colorado s uninsured children
Colorado’s Uninsured Children
  • 176,000 “best estimate” of uninsured
    • 115,000 Eligible but not enrolled (EBNE)
    • 12,000 newly eligible (205-250% expansion, May 1)
    • 33,500 uninsured – in the gap between public and private
    • 16,000 ineligible for public coverage because of immigration/documentation
remarkable gains
Remarkable Gains
  • 2007 - Medical Home, state level advisory committee, presumptive eligibility
  • 2008 – Administrative renewal, CHP+ expansion
  • 2009 – Ex-parte renewal, major expansions through Colorado Healthcare Affordability Act, eligibility modernization efforts
  • 2010 – Patient Protection and Affordable Care Act
  • 2010 – Maternity coverage mandate, birth certificate fee waiver, food stamp program improvements
colorado healthcare affordability act
Colorado Healthcare Affordability Act
  • Eligibility Expansions
    • Parents with children in Medicaid with incomes up to 100% FPL – May 1, 2010
    • CHP+ children and pregnant women with incomes up to 250% FPL – May 1, 2010
  • Program Improvements
    • Quality incentive and increased payments - 2010
    • 12 months continuous eligibility – Spring 2012
patient protection and affordable care act
Patient Protection and Affordable Care Act
  • Private Market Regulation
  • Provider Payment/Care Delivery
  • Medicaid Expansion and Improvement
  • Exchange based coverage
  • CHIP
private market regulation
Private Market Regulation
  • Children under 19 with private insurance can no longer be denied coverage for pre-existing conditions – September 23, 2010.
  • New plans must provide free preventive services to enrollees.
  • Plans can no longer impose lifetime caps or annual limits and can not rescind coverage when a person becomes ill.
provider payment care delivery
Provider Payment/Care Delivery
  • Increase in Medicaid payments for primary care services provided by primary care doctors with 100% federal funding. Jan 1, 2013 – December 31, 2014.
  • Patient Centered Outcomes Research Institute
  • Center for Medicare and Medicaid Innovation
  • Pediatric Accountable Care Organizations
medicaid
Medicaid
  • Creates maintenance of effort requirements.
  • Eliminates the stairstep allowable under current Medicaid law so that all children under 19 living in families with incomes below 133% of FPL become eligible for Medicaid.
  • Designates Medicaid as the coverage pathway for low-income Americans, situating firmly in the national coverage framework.
exchange based coverage
Exchange Based Coverage
  • American Health Benefit Exchanges – 1.1.14
  • Small Business Health Options Program Exchanges – businesses up to 100 employees
  • Only way to buy subsidized private coverage for individuals/families with income between 133% - 400% FPL.
  • Four levels of qualified plans – Bronze, Silver, Gold and Platinum.
slide13
CHP+
  • Creates maintenance of effort requirements
  • Reauthorizes CHIP (Child Health Plan Plus) through 2019 with full funding through 2015.
  • In 2015, states can choose to continue program or close and kids will be required to get coverage through exchange or in the private market.
key issues
Key Issues
  • Public Understanding and Support
  • Creating a Culture of Coverage
  • Eligibility Determination and Enrollment
  • Ensuring System Capacity
public engagement
Public Engagement
  • 19% trust the federal government to do the right thing most of the time.
  • 44% of public “confused” about reform in May
  • Understanding of impact related to family income
  • Main reason for favorable opinion: Expanding access to health insurance and access to care
  • Main reason for unfavorable opinion: Financial and cost considerations and govt. related issues
message
Message

“Health reform is a major victory for children and families. It delivers what families need: affordable reliable health coverage that won’t disappear if they lose a job or get sick.”

creating a culture of coverage
Creating a Culture of Coverage
  • 49th in the nation covering kids living in poverty!!! Fully one-third of our most vulnerable children are uninsured.
  • Parent expansion under the Colorado Healthcare Affordability Act – Cover Families
  • “Strategic moment to recast Medicaid as an affordable health coverage program for working people and families.”
eligibility systems
Eligibility Systems
  • “To put it bluntly, 36 million Americans cannot be enrolled in Medicaid or the new exchanges by relying upon…the cumbersome and intrusive processes of the welfare eligibility system.”
  • Parents expansion glitch
  • System and community capacity
delivery system capacity
Delivery System Capacity
  • 58,000 estimated uninsured kids without a usual source of care (33% of 176,000)
  • 53,000 estimated eligible parents - CHI
  • 120,000 estimated eligible adults without dependent children - CHI
  • Community clinic and private provider capacity, human services capacity
why we must succeed
Why We Must Succeed
  • The Colorado Health Foundation Report Card D+
  • Kids Count
  • Stewardship – taking responsibility to protect something fragile and precious and deliver it for the future

Our Opportunity is now. Colorado kids can’t wait.

start today
Start Today
  • Jeff Bontrager, CHI
  • Heather Hewitt, HCPF
  • Breakout Sessions
    • Parents
    • Updates
  • Reconvene sharing, inspiration and food!