1. Yes We Can... Cover 4 Million Uninsured Children Jennifer Sullivan, MHS Senior Health Policy Analyst Families USA 202-628-3030 jsullivan@familiesusa.org Families USA – Health Action Conference January 29, 2009

2. Key Questions How much longer until CHIP is reauthorized? Whats in the bill? What does it mean for my state?

3. Background Hi, Im new here. What is CHIP?

4. How much longer until CHIP is reauthorized? House bill already passed with 289 votes Senate bill passed in committee, floor vote scheduled this week Conference committee

5. What does the House bill (H.R. 2) do? Reauthorizes CHIP through end of FY 2013 Covers 4.1 million uninsured children Pay-for: 61-cent increase in federal tobacco tax Cost: $32.3 billion over 4.5 years

6. Who Does It Cover? Source: CBO Preliminary Estimate of Changes in SCHIP and Medicaid Enrollment in Fiscal Year 2013 of Children Under the Children's Health Insurance Program Reauthorization Act of 2009, January 2009. Total: 4.1 million uninsured children

7. Financing $ (Billions)

8. Financing Funnels funding to states that use it Allotments available two years Contingency fund 2009 allotments are an average 96% higher under the new formula than under current law

9. Who is eligible? Children – different matching rate depending on income (above/below 300% of poverty) Pregnant women – no waiver needed Legal immigrant children and pregnant women – newly eligible, no 5-year waiting period Parents – new restrictions Childless adults – new restrictions

10. Getting more children enrolled Performance Bonuses Medicaid enrollment benchmarks Qualifying activities –12 month continuous eligibility –Eliminate asset tests/allow administrative verification –Eliminate face-to-face interview requirements –Presumptive eligibility –Single Medicaid/CHIP application –Express lane eligibility –Passive/ex-parte renewal

11. Getting more children enrolled Express Lane Eligibility $100 million in outreach grants

12. Other improvements Benefits Dental coverage Mental health parity Clarifies EPSDT required in benchmark plans Quality Improved quality measurement Electronic medical records for children Child obesity demonstration

13. Senate Bill (S. 275) Similar to House except: Performance Bonus Qualifying Activities – adds premium assistance Pay-fors – no specialty hospital provision Dental wrap – for children with private health coverage but no dental Immigrant documentation requirement MACPAC/Trustees report Actuarial Soundness study

14. What does CHIP Reauthorization mean for states?

15. Stable funding through 2013, but... Use it or lose it.

16. Are states ready to move forward? States with projected budget deficits in FY2009 or FY2010 Alaska: no Hawaii: yes Source: Center on Budget & Policy Priorities, January 14, 2009

17. What Should I Do When the CHIP bill is signed?

18. Educate state policymakers about new financing rules Prevent proposed cuts Adopt simplified outreach, enrollment, and retention policies Adopt express lane eligibility Cover legal immigrant children and pregnant women

19. Other issues to think about Does my state use CHIP funds to cover parents? Does my state use CHIP funds to cover other adults?

20. More information Families USA www.familiesusa.org Stand Up for Health Care www.standupforhealthcare.org