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
"All great achievements require time."
~ Maya Angelou
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Featured Article
Aaron E. Carroll
The New York Times
May 19, 2014
Health insurance deductibles, coinsurance, and copays are categories of expenses that individuals pay out of pocket - in addition to health policy premiums - for health services. Insurance companies impose these types of cost-sharing to deter healthy individuals from seeking unnecessary care. But, does cost-sharing also deter individuals with chronic conditions from obtaining the care they need to stay as healthy as possible? Do they delay care until their condition worsens and they are hospitalized at greater expense to both the insurer and themselves? This article is based on the investigation Financial Barriers to Care among Low-Income Children with Asthma, which found that cost-sharing can be a deterrent to seeking necessary care. Privately insured families with limited income who incurred high out-of-pocket costs for their children with asthma were more likely to delay or forgo their child's care, to have less money for other household expenses, and to experience financial hardship. This is in contrast to families whose children with asthma are enrolled in Medicaid or the Children's Health Insurance Plan (CHIP), where there is no or low cost-sharing. The author notes that other countries use a sliding scale to determine cost-sharing based on an individual's health status or waive copays for individuals with chronic conditions and suggests the U.S. might also adopt these types of strategies. Note: Learn more about Medical Debt and Family Financial Hardship on the Publications & More page of the Catalyst Center website. |
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 IN THIS ISSUE
News Items
Resources
Events and Announcements
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News Items
States Consider Using Medicaid to Pay College Health Plan Premiums 
By Michelle Andrews
Kaiser Health News
May 27, 2014
There are new pathways to health insurance for young adults, thanks to several provisions of the Affordable Care Act (ACA). Young adults can now remain on a parent's health insurance policy until they turn 26. Youth who have aged out of foster care may keep the Medicaid benefit, regardless of income, until age 26. And, in states that have implemented the Medicaid expansion, 19- to 64-year-olds who are not disabled or pregnant and with household income less than 133% of the federal poverty level can enroll in Medicaid. In some states, college students who are eligible for Medicaid may have yet another option for health insurance. In Montana and Minnesota, Medicaid is paying the student health insurance plan premiums for college students who are enrolled in Medicaid. Utilizing the college's student health plan, rather than Medicaid, may give eligible students access to a wider range of health providers. In particular, the student health plan provider network may provide a more robust mental health benefit, an increasingly prevalent need for college students. While there will be limitations for out-of-state students, Cornell University in New York is considering this option for several hundred incoming students who are enrolled in Medicaid. For students who are younger than 21, Medicaid will continue to provide needed wrap-around coverage through the EPSDT (Early and Periodic Screening, Diagnosis and Treatment) benefit.
ACA and the Children's Health Insurance Program
By Christine Vestal
Stateline
May 21, 2014
The Children's Health Insurance Program (CHIP) is a public benefit program for children whose families do not have access to other affordable health insurance and whose income is too high for Medicaid. Between 1997, when the program started, and 2012, CHIP has been instrumental in reducing the number of children without insurance. CHIP is authorized until 2019, at which time a state can decide to end its program. If states discontinue CHIP and the family glitch is not resolved, children will lose an important safety net program, and families will incur higher insurance costs as, depending on the cost of the health premiums for just the employee, the family may not be eligible for subsidized marketplace insurance. This article discusses the role of CHIP in the era of health reform, how children's medical, mental, behavioral, and dental benefits may change, and the potential differences in cost-sharing if children move from CHIP to marketplace coverage.
Note: Want to know more about Medicaid and CHIP? Read Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and the Children's Health Insurance Program (CHIP).
By Meghanne Bearden
Health Policy Hub
May 22, 2014
In general, the Affordable Care Act's (ACA) first open-enrollment period was successful, with more than 8 million people signing up for health coverage in the marketplaces. This good news was tempered by the low enrollment of Hispanics. While nationwide enrollment of this key demographic was low, New Jersey was able to double the enrollment numbers of Latinos in the last month of open enrollment by targeting areas of the state with large communities of Latinos, many of whom were uninsured. The New Jersey Citizen Action group chose community-based organizations with strong ties to community health clinics and other social service organizations. Staff were trained as certified application counselors, they used read-aloud pens to help consumers with literacy issues, and paired insurance enrollment with free tax assistance.
By Michelle Diament
Disability Scoop
May 19, 2014
In 1999, the U.S. Supreme Court ruled that it was a violation of the Americans with Disabilities Act (ADA) to segregate individuals with disabilities. This case, known as the Olmstead v. L. C. decision, states that individuals with disabilities who want to live at home and participate in community life must be provided with the community-based services and supports they need to do so. However, a July 2013 report, Separate and Unequal: States Fail to Fulfill the Community Living Promise of the Americans with Disabilities Act, found that states continue to maintain long waiting lists for community-based services, and they are not making sufficient progress at moving individuals from institutions to community settings. In response, Senator Harkin of Iowa is looking to create legislation to ensure individuals with disabilities have the needed supports to move from institutional settings to housing in the city or town of their choice.
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Resources
By Kasey Wilson, Melissa Hirschi, Margaret Comeau, Suzanne Bronheim, and Sara S. BachmanHealth & Social Work May 27, 2014 Almost half of all social workers work with children, families, and schools. This close proximity to children, including children with special health care needs (CSHCN), provides social workers with a unique opportunity to help reduce health insurance disparities among CSHCN based on race or ethnicity, immigration status, language spoken at home, household income, and functional limitations. This article by Catalyst Center staff and the National Center for Cultural Competence discusses policy and practice initiatives and administrative improvements that will help social workers promote health insurance coverage as well as advance social justice and cultural competency.
By Calvin Kagan and Kate Lewandowski
Community Catalyst
May 2014
On January 1, 2014, Section 2004 of the Affordable Care Act (ACA) went into effect. This Section allows youth who have aged out of the foster care system and, moving forward, those who will age out, to reenroll in Medicaid or continue to receive the Medicaid benefit until they turn 26. This paper from Community Catalyst provides an overview of the housing, employment, and health challenges faced by children and youth in the foster care system. It also profiles state officials' and advocates' efforts to not only identify and enroll youth who have aged out of foster care in Medicaid, but also to educate them about retaining and using the benefit. There are examples of how some states are using Medicaid State Plan Amendments and legislation to extend this benefit to youth who aged out of foster care in one state and have moved to another.
By Leslie Acoca, Jessica Stephens and Amanda Van Vleet
The Kaiser Commission on Medicaid and the Uninsured
May 19, 2014
The majority of youth in the juvenile justice system have significant unmet and undiagnosed health needs that include a range of physical, mental, behavioral, dental, and medical (including sexually transmitted infections and HIV/AIDS) conditions. There are standards for providing health services to youth in juvenile detention facilities, but they are voluntary. There is also variation in how the services are provided; some counties use public health services or contract with private correctional health providers. Most youth in the juvenile justice system are eligible for Medicaid or the Children's Health Insurance Program (CHIP), either because they are "crossover" youth who are also involved in the child welfare system or because they are categorically eligible due to limited income. Youth enrolled in Medicaid at the time of their detention can retain the benefit, but due to the Medicaid and CHIP "inmate exclusion," public detention facilities cannot receive federal matching funds for the cost of medical services unless the individual is in a medical facility or in a hospital. Many states terminate a youth's Medicaid or let it lapse while the individual is being held. Youth in detention cannot be enrolled in CHIP. This report discusses the need for improved health services for youth in the juvenile justice system. It also addresses the importance of enrolling or reenrolling them in Medicaid upon release and of connecting them to community health providers to ensure continuity of care for their ongoing health needs. Improved and expanded data collection is also necessary in order to assess and track the needs of this vulnerable population of youth.
News From Our Partners
The new and improved Center for Health Care Strategies (CHCS) website is easier to navigate. Visitors can easily explore the content and learn about CHCS's focus areas, projects, and resources. New features include the CHCS Blog, where readers can learn about and comment on innovations to improve quality and cost-effectiveness of Medicaid and other public health insurance benefits.
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Events & Announcements
Date: June 18, 2014
Time: 2:00 to 3:00 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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