Catalyst Center Coverage
Roundup of news related to financing of care for children and youth with special health care needs |
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Quote of the Week
"Never was good work done without much trouble."
~ Sudanese proverb
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Featured Article
By Robert Pear
The New York Times
March 26, 2014
On Tuesday, March 25, President Obama's administration announced it would Extend the Sign-Up Period for health insurance. Several states running their own marketplaces also extended the deadline. These extensions created a "special enrollment period" for people who tried to enroll in health insurance prior to the March 31 deadline but were unable to complete the process due to technical difficulties in the federal and some state-run Marketplaces. On March 26, the Administration announced that legal immigrants who were denied coverage, those enrolled in the wrong plan, people who were denied Medicaid because their information was not correctly transferred, those with "complex cases," and victims of domestic violence would also have more time to enroll. As a protection, those who have experienced domestic violence will not have to file a joint tax return in order to receive federal subsidies. Those granted a special enrollment period have 60 days to complete their applications. Anyone wanting health coverage by May 1, 2014 must complete enrollment and begin paying premiums by April 15.
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Resources
Events and Announcements
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News Items
By Rebecca Adams
The Commonwealth Fund
March 24, 2014
The March report from the Medicaid and CHIP Payment and Access Commission (MACPAC) includes two recommendations for the Children's Health Insurance Program (CHIP). Historically, states instituted waiting periods - periods of time that children had to be uninsured - before they were eligible to enroll in CHIP. Currently, 13 states do not have waiting periods; 19 have waiting periods of three months or less. The waiting periods in the remaining states range from 4 to 12 months, although some states have established income-related exemptions for the CHIP waiting period. To promote continuous coverage for children, MACPAC recommends that Congress eliminate all CHIP waiting periods. The Commission also recommends eliminating premiums for children enrolled in CHIP programs whose family income is less than 150% of the federal poverty level (FPL). All children, birth to 19, whose household income is less than 133% FPL are eligible for Medicaid. Many states use higher income eligibility for children's Medicaid, but none charge premiums for household income less than 150% FPL. Eliminating CHIP premiums would level the playing field in states that charge premiums for children enrolled in CHIP whose family income is between 133% and 150% FPL. This would actually save money, as the premiums generate less revenue than the administrative costs of collecting them. The June MACPAC report will include information about cost sharing, benefits, and other elements of CHIP.
By Cathy Hope
Say Ahhh! A Children's Health Policy Blog
March 28, 2014
It's common knowledge that children are more likely to have health insurance when their parents are also insured. This blog, by Cathy Hope at the Center for Children and Families, provides an overview of a Health Policy Brief by the Maine Children's Alliance that provides the data to support the maxim that "covering parents is good for kids." Prior to 2012, income eligibility for Maine's Medicaid program was 200% FPL for children, parents, and pregnant women. In 2012, Maine's legislature reduced the Medicaid income eligibility for parents from 200% to 100% of the federal poverty level (FPL). As a result, since February 2013 there has been a significant decline is the number of children with household income between 150% and 200% FPL who are enrolled in Medicaid. Recommendations for ensuring that parents, new mothers, and children receive preventive services as well as needed medical care include eliminating the waiting period for CHIP and implementing the adult Medicaid expansion for adults.
By Michelle Diament
Disability Scoop
March 27, 2014
The Centers for Disease Control and Prevention (CDC) estimates that 1 in 68 children have autism, up from 1 in 88 children reported in 2012. The increasing incidence will mean an increasing need for medical, behavioral and other support services. This new estimate is based on record reviews of 8-year-old-children in 11 communities throughout the country who were treated by professionals who provide educational and health services to children with developmental disabilities. Disparities exist based on sex, geography, and race. Boys are five times more likely to receive an autism diagnosis than girls are. Prevalence is higher in New Jersey than in Alabama. Children who are white are more likely to be diagnosed with autism than children who are black or Hispanic.
MedlinePlus
March 18, 2014
As children get older, they assume an increased number of responsibilities. They are also at increased risk of developing mental health needs. This article reports on the 80% increase in, and high cost of, hospitalizations for children with mental health disorders. With a shortage of mental health providers, who's responsible for caring for children with mental health needs in the community and in the hospital? Investigators are examining pediatric inpatient databases and working to develop best practices for treatment to prevent hospitalizations. They are also working to provide continuity of care for children and youth who transition from inpatient settings back home.
PR Web March 13, 2014 On March 13, U. S. Representative Michelle Lujan Grisham of New Mexico introduced the Health Equity & Access under the Law (HEAL) for Immigrant Women & Families Act of 2014 (H.R. 4240) in the House of Representatives. If passed, lawfully present immigrant women and children who meet their state's residency and income requirements for Medicaid and CHIP will be able to enroll in these public health insurance programs without the current five-year waiting period. The Legal Immigrant Children's Health Improvement Act (ICHIA), passed as part of the Children's Health Insurance Program Reauthorization Act in 2009, gave states the option to waive the five-year ban for lawfully present children and pregnant women. As of March 2014, 27 states and the District of Columbia (D.C.) have taken up this option for children's Medicaid; 21 states have done the same for CHIP. (See the list of states that extend Medicaid and CHIP Coverage to Lawfully Residing Children and Pregnant Women.) If passed, H.R. 4240 would also allow individuals living in this country under Deferred Action for Childhood Arrivals (DACA) status to be eligible for Medicaid, CHIP, or federal subsidies to enroll in Marketplace coverage, depending on income.
By Michelle Andrews
Kaiser Health News
March 25, 2014
Michelle Andrews explains why there may be differences between new individual and small-group health plans sold inside and outside of the Marketplace, even though the Affordable Care Act (ACA) mandates that they all provide the ten essential health benefits. (Reasons include: not all insurers sell plans in the marketplace, provider networks can differ, and plans outside the marketplace may offer slightly different benefits.) She also explains that if tax credits and cost-sharing subsidies adjust a family's deductible to less than $2,500, they will not be able to contribute to a health savings account (HSA) and save before-tax dollars for medical expenses. Andrews concludes with a discussion about who pays the tax penalty for an uninsured 19-year-old whose family claims him as a dependent (Spoiler alert: the family, and the penalty will be based on household income.) |
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Resources
By Robin Rudowitz, Samantha Artiga, and Rachel Arguello The Henry J. Kaiser Family Foundation
March 26, 2014Together, Medicaid and the Children's Health Insurance Program (CHIP) provide health benefits to more than 33 million children. This issue brief provides an overview of how each program is financed and the changes that have occurred due to the Affordable Care Act (ACA). It also explores the implications for children and families if funding for CHIP is not reauthorized in 2015. By Kate Lewandowski Community Catalyst
March 20, 2014 There are many reasons that individuals move in and out of coverage provided by Medicaid and the Children's Health Insurance Program (CHIP). The phenomenon of gaining, losing, and regaining coverage is known as "churn." Gaps in health insurance due to churn mean children may miss important preventive care visits. Gaps in coverage have bigger implications for children and youth with special health care needs who require preventive care and who are at greater risk for unanticipated health services due to underlying medical, mental, and behavioral health needs. Community Catalyst has developed a Churn Toolkit that explores the cost of churn, how to identify state partners on efforts to reduce churn, policy solutions, and more.
This series of three fact sheets, while specific to children with special health care needs (CSHCN) in the California school system is widely applicable to other states. Children with Special Health Care Needs: Lost at School? describes the challenges of identifying CSHCN, often caused by misinterpretations of existing special education laws that create communication barriers and limit exchange of medical information. Children with Special Health Care Needs: Who Is Caring for Them at School? notes that an increasing number of CSHCN are attending school at a time when there are fewer school nurses. They found that only 26% of nurses are "very to extremely confident" they are meeting the health needs of all their students, and that other non-medical school staff are providing health care services. The third fact sheet, Children with Special Health Care Needs: Underfunding Leaves Children without Services discusses potential sources of funding for school nurse services that could bring additional revenue to schools so they could employ more nurses. The authors provide policy recommendations that would mitigate these three issues.
News From Our Partners
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Events & Announcements
Date: April 24, 2014
Time: 12:00 - 1 pm ET
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Want more news?
To view more articles from past issues of Catalyst Center Coverage, visit the Catalyst Center website. For state-specific news, visit the Catalyst Center Facebook page.
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News to share?
If you have suggestions for news items related to coverage and financing of care for CYSHCN please email Beth Dworetzky Catalyst Center Coverage editor and Catalyst Center Project Director by 12 noon on Friday.
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The Catalyst Center is a national center dedicated to working with states and stakeholder groups on improving health care insurance and financing for Children and Youth with Special Health Care Needs (CYSHCN). For more information, please visit us at www.catalystctr.org or contact Meg Comeau, Co-Principal Investigator, at mcomeau@bu.edu.
The Catalyst Center is funded under cooperative agreement #U41MC13618 from the Division of Services for Children with Special Health Needs, Maternal and Child Health Bureau, Health Resources and Services Administration, U.S. Department of Health and Human Services. Kathleen Watters, MA, MCHB/HRSA Project Officer. The contents of Catalyst Center Coverage are solely the responsibility of the authors and do not necessarily represent the views of the funding agencies or the U.S. government.
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