CoverKids Kinika Young Director of Childrens Health Tennessee Justice Center Andy Schneider Research Professor of the Practice Georgetown University Center for Children and Families May 17 2017 ID: 759150
Download Presentation The PPT/PDF document "Protecting Tennessee's Children: CHIP (..." is the property of its rightful owner. Permission is granted to download and print the materials on this web site for personal, non-commercial use only, and to display it on your personal computer provided you do not modify the materials and that you retain all copyright notices contained in the materials. By downloading content from our website, you accept the terms of this agreement.
Slide1
Protecting Tennessee's Children: CHIP (“CoverKids”)
Kinika YoungDirector of Children’s HealthTennessee Justice CenterAndy SchneiderResearch Professor of the PracticeGeorgetown University Center for Children and FamiliesMay 17, 2017
Slide2CoverKids
CoverKids is Tennessee’s CHIP program CoverKids provides health insurance for eligible children age 18 and younger and for eligible pregnant women.
2
Slide3Public Coverage for TN Children, 2016
3
Medicaid
874,000
CHIP
106,000
Marketplace
19,000
Sources: SEDS FY 2016 Ever-Enrolled in Medicaid/CHIPASPE. “Health Insurance Marketplaces 2016 Open Enrollment Period: Final Enrollment Report.”
Slide4Children on Medicaid/CHIP by Congressional District
Source: American Community Survey, Single-Year Estimates, 2015.Note: In the lowest range, data greater than or equal to the lower limit and less than or equal to the upper limit. In subsequent ranges, data are greater than the lower limit and less than or equal to the upper limit.
4
43-52%
35-43%
26-35%
Slide55
Children’s Coverage Rate Increasing
Source: CCF analysis of ACS single-year data, 2008-2015
Slide6Tennessee’s CoverKids Budget, FY 2016
The federal match rate for TN is 98.54%. This means: State Share - $2,744,187Federal Share - $185,213,814
6
Slide7CoverKids Eligibility
ChildrenThey are under 19 years of age on the date of application;They are Tennessee residents;They are not eligible for or enrolled in TennCare;They are U.S. citizens or qualified legal aliensTheir household income is at or below 250% of federal poverty level (FPL).Unlike TennCare, CoverKids cannot be used as a second plan
7
Slide8CoverKids Eligibility
Pregnant WomenThey are Tennessee residents;They do not have to show immigration documents; They are not eligible for or enrolled in TennCare; andTheir household income is at or below 250% of federal poverty level (FPL). If you have a health plan without maternity benefits, you can apply for CoverKids
8
Slide92017 Federal Poverty Guidelines
9
Slide10Application Information
Applicants applying for coverage must apply online at healthcare.gov or call toll-free1-800-318-2596Administered by BlueCare via Health Care Finance and Administration“No wrong door” provision
10
Slide11Premiums and Cost Sharing
No premiumsTotal cost-sharing cannot exceed 5% of family income Cost-sharing varies based on income and serviceNo cost sharing for well-baby and well-child care, including immunizations.
Slide12Benefits
Medicaid-CHIP program (“TennCare Standard”) – same packageSeparate CHIP (“CoverKids”) - “benchmark plan”
Slide13How do CoverKids Benefits Compare?
CoverKids provides low-cost, comprehensive health coverage through a managed care planCovers preventative health services, doctor visits, hospital visits, vaccinations, well-child visits, developmental screenings and mental healthChildren also get vision and dental care.
13
Source: “Benefits and Cost Sharing in Separate CHIP Programs,” National Academy for State Health Policy & Center for Children and Families (May 2014) available at http://ccf.georgetown.edu/wp-content/uploads/2014/05/Benefits-and-Cost-Sharing-in-Separate-CHIP-Programs.pdf
Slide14Children’s Health Insurance Program (CHIP)
Passed in 1997 to help states provide coverage to uninsured children who do not qualify for MedicaidBlock grant with capped annual allotments to statesFederal government pays 65% to 85% of costs (E-FMAP); with a 23% percentage point bump in 2016-17 up to annual allotmentStates administer and have flexibility to design eligibility, benefits, cost-sharing, payments beyond federal minimums
14
Slide15CHIP Reauthorization (CHIPRA)
On February 4, 2009, just three weeks into his term as the 44th President of the United States, Obama signed into law the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA).
“In a decent society, there are certain obligations that are not subject to tradeoffs or negotiation - health care for children is one of those obligations.”
President Obama, in signing CHIPRA, February 4, 2009
Slide16MACRA: Medicare Access and CHIP Reauthorization Act (2015)
Part of larger package to permanently prevent cuts to Medicare payment rates for doctors, also called “doc fix”“Clean” CHIP extension through 2017Funds ACA’s 23 percentage point increase in match rate for 2016 and 2017New outreach funds
16
Slide17CHIP: Federal-State Partnership
Federal GovernmentStatesAdministrationOversightDirect administrationFinancingPay 65% to 81% of costs, up to cap; ACA/MACRA increased by 23 percentage points through at least 2017 to maximum of 100%Pay a share of cost (if under 100% federal matching rate)Program RulesMinimum standards- more flexibility relative to MedicaidSets provider payment rates and decides eligibility rules, benefits, and cost sharing within guidelinesCoverage GuaranteeNone requiredCan freeze or cap enrollment (ACA prohibits this until 2019 with some exceptions!)
Slide18Children's Health Insurance Program (CHIP) Financing
Block grant with capped annual allotmentsUnused allotment available for up to 2 yearsContingency fund covers shortfallsACA bump = 23 percentage points up to 100% starting in FFY 2016
18
eFMAP FormulaFMAP + (0.3 x (1 – FMAP))
2017 eFMAP Rates2017 eFMAP with BumpMinimum65%88%Tennessee75.47%98.47%Maximum82.2%100%
Source: ASPE “FMAP 2017 Report.” Valid October 1, 2016-September 30, 2017.
Slide19CHIP Not a Typical Block Grant
Adequate initial funding levels. The program’s original ten-year authorization more than met states’ projected need.Redistribution. Unused funds from low-spending states are redistributed to states in need of additional funds.Shortfall funding. Congress stepped in multiple times to provide additional targeted funds allowing states to operate their CHIP programs as if they weren’t capped.Funding extension permits growth. CHIP’s later funding extensions included increases to accommodate health care cost inflation, population growth, and program growth.Contingency fund. Dedicated fund to prevent enrollment-related shortfalls.
19
Slide20CHIP Funding
20
Congress must act before September 30, 2017 to extend CHIP fundingTogether, Medicaid and CHIP have driven our success in covering childrenCHIP is popular program that has bipartisan support – a clean extension NOW could be a win for both sides and stabilize kids’ coverageUncertainty about Medicaid and the future of the marketplaceWill it be used as leverage in gaining support for detrimental changes to Medicaid?
Slide21Why is Health Coverage Important for Children?
Access to preventive care to detect and treat delays or diseaseHealthy children better able to learn in schoolEnsure long-term productivity and success in lifeFamily financial security
Source: A. Chester, J. Alker, “Medicaid at 50: A Look at the Long-Term Benefits of Childhood Medicaid,” Georgetown University Center for Children and Families (July 2015).
21
Slide22What Happens to Kids without CHIP?
22
Public/Medicaid
Exchange Marketplaces, Employer-Sponsored Insurance, Other
Some Could Become Uninsured
Slide23Tools for Organizations
Children’s landing pageBranded and unbranded fact sheets and shareable imagesMonday, Wednesday and Friday Facebook children’s posts at 2:30 pm CDT Please let us know what you need
23
Slide24How to Get Involved
Join our email list for timely updates Let us know if you have any stories of families who benefit from CHIP for our story bank
24
Slide25Children’s Health Team
25
Kinika Young,
Director of Children’s Health
Anna Walton,
Health Action Associate
De Vann Sago, King Child Health Fellow
Slide2626
Questions?