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K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Childrens Coverage: The Role of Medicaid & SCHIP Diane Rowland, Sc.D. Executive.

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Presentation on theme: "K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Childrens Coverage: The Role of Medicaid & SCHIP Diane Rowland, Sc.D. Executive."— Presentation transcript:

1 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 0 Childrens Coverage: The Role of Medicaid & SCHIP Diane Rowland, Sc.D. Executive Vice President, Henry J. Kaiser Family Foundation and Executive Director, Kaiser Commission on Medicaid and the Uninsured for Alliance for Health Reform Washington, DC February 2, 2009

2 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 1 Health Insurance Coverage of Children, Million Children NOTES: Data may not total 100% due to rounding. Children includes all individuals under age 19. SOURCE: Kaiser Commission on Medicaid and the Uninsured/Urban Institute analysis of 2008 ASEC Supplement to the CPS. Private Non- Group 4%

3 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 2 Growing Medicaid and SCHIP Enrollment of Children, FY 1998 – FY 2005 SOURCE: Kaiser Commission on Medicaid and the Uninsured and Urban Institute analysis of HCFA-2082, MSIS, and SEDS data, Millions of Children

4 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 3 Childrens Access to Care, by Health Insurance Status, 2007 * In the past 12 months Questions about dental care were analyzed for children age Respondents who said usual source of care was the emergency room were included among those not having a usual source of care. SOURCE: KCMU analysis of 2007 NHIS data.

5 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 4 Key Differences Between Medicaid and SCHIP in Childrens Coverage MedicaidSCHIP Enrolled 28.3 million6.1 million Coverage Required for newborns to age 6 up to 133% FPL and 6-19 at 100% FPL with state option to go above Above Medicaid levels (44 states 200% FPL) Entitlement To Beneficiaries and StatesTo States Financing Guaranteed Federal MatchCapped Financing Enrollment Caps Not permittedPermitted Matching Rate Regular Match Rate (average 57%)Enhanced Match Rate (average 70%) Scope of Coverage Option to impose benchmark benefits, EPSDT Wrap-Around Coverage Benchmark Benefits, no mandate for EPSDT Cost-Sharing and Premiums Generally, not allowed for mandatory children; premiums allowed >150% FPL Permitted but limited

6 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 5 Median Medicaid/SCHIP Income Eligibility Thresholds for Children, Pregnant Women and Parents, January 2009 SOURCE: Based on a national survey conducted by the Center on Budget and Policy Priorities for KCMU, Federal Poverty Line for a family of three ($17,600 per year in 2008) Percent of Poverty

7 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 6 Childrens Eligibility for Medicaid/SCHIP by Income, January 2009 AZ AR MS LA WA MN ND WY ID UT CO OR NV CA MT IA WI MI NE SD ME MOKS OH IN NY IL KY TN NC NH MA VT PA VA WV CT NJ DE MD RI HI DC AK SC NM OK GA *The Federal Poverty Line (FPL) for a family of three in 2008 is $17,600 per year. ***IL uses state funds to cover children above 200% FPL.; MA uses state funds to cover children above 300% FPL; NY uses state funds to cover children from 250% to 400% FPL; WI uses state funds to cover children from 250% to 300% FPL. SOURCE: Based on a national survey conducted by the Center on Budget and Policy Priorities for KCMU, TX IL FL AL < 200% FPL (7 states) >250% FPL (11 states & DC) % FPL (33 states)

8 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 7 Simplifying Enrollment and Renewal: Strategies States are Using in Childrens Health Coverage Programs, Jan 09 SOURCE: Based on a national survey conducted by the Center on Budget and Policy Priorities for KCMU, Number of States: Figure 7

9 K A I S E R C O M M I S S I O N O N Medicaid and the Uninsured Figure 8 The Nonelderly Uninsured, by Age and Income Groups, 2007 Total = 45.0 million uninsured Low-income includes those with family incomes less than 200% of the federal poverty level. SOURCE: KCMU/Urban Institute analysis of March 2008 CPS. Adults without Children 21% <200% FPL 200% FPL +


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