Improving coverage for children under health reform will require maintaining current eligibility standards for medicaid and chip

Health Affairs

Volumn 30, Issue 12, 2011, Pages 2371-2381

  Kenney, Genevieve M ^a   Buettgens, Matthew ^a   Guyer, Jocelyn ^b   Heberlein, Martha ^b  

^a URBAN INSTITUTE   (United States)

^b GEORGETOWN UNIVERSITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; FUNDING; HEALTH CARE POLICY; HEALTH INSURANCE; HUMAN; MEDICAID;

CHILD; CHILD HEALTH SERVICES; ELIGIBILITY DETERMINATION; HEALTH SERVICES ACCESSIBILITY; HEALTH SERVICES NEEDS AND DEMAND; HUMANS; INSURANCE COVERAGE; MEDICAID; MEDICALLY UNINSURED; PATIENT PROTECTION AND AFFORDABLE CARE ACT; UNITED STATES;

EID: 84855699847     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.2011.0899     Document Type: Article

References (19)

1. DeNavas-Walt C, Proctor B, Smith J. Income, poverty, and health insurance coverage in the United States: 2010. Washington (DC): Census Bureau; 2011.
2. Kenney G, Lynch V, Cook A, Phong S. Who and where are the children yet to enroll in Medicaid and the Children's Health Insurance Program? Health Aff (Millwood). 2010;29(10):1920-9.
3. Heberlein M, Brooks T, Guyer J, Artiga S, Stephens J. Holding steady, looking ahead: annual findings of a 50-state survey of eligibility rules, enrollment and renewal procedures, and cost sharing practices in Medicaid and CHIP, 2010-2011. Washington (DC): Georgetown University Center for Children and Families, Kaiser Commission on Medicaid and the Uninsured; 2011.
4. Georgetown University Center for Children and Families. The Children's Health Insurance Program Reauthorization Act of 2009: overview and summary. Washington (DC): The Center; 2009.
5. Kenney G, Pelletier J. How will the Patient Protection and Affordable Care Act of 2010 affect children? Washington (DC): Urban Institute; 2010.
6. A standard disregard of 5 percent will be applied
7. Specifically, the Affordable Care Act requires states to maintain the Medicaid and CHIP eligibility rules and enrollment procedures in effect on March 23, 2010, for children through 2019
8. Starting October 1, 2015, states are slated to receive an increase of twenty-three percentage points in their CHIP matching rate if new federal funding becomes available
9. State Flexibility Act, S. 868, 112th Cong., 1st Sess. (2011).
10. Department of the Treasury. Health insurance premium tax credit. Fed Regist. 2011;76(159):50931-49.
11. There is controversy over whether the Affordable Care Act requires the use of an employee-only affordability test when assessing whether families are eligible for exchange subsidies. A proposed rule issued by the Department of the Treasury in August 2011 adopts this interpretation (as did the Joint Committee on Taxation in its modeling of the impact of the Affordable Care Act). Analysts have argued that the law could be read as excluding families from exchange subsidies only if the cost of familybased insurance (rather than employee-only insurance) is less than 9.5 percent of income. For purposes of this analysis, we followed the Joint Committee on Taxation's assumption that the employee-only test applies, but this issue is the subject of further work and analysis (see Note 10).
12. Watson Wyatt Worldwide. Implications for health care reform for children currently enrolled in CHIP programs [Internet]. Washington (DC): Watson Wyatt Worldwide; 2009 [cited 2011 Nov 15]. Available from: http://www.firstfocus.net/sites/default/files/r.2009-10.1 .watson.pdf
13. McMorrow S, Kenney G, Coyer C. Addressing coverage challenges for children under the Affordable Care Act. Washington (DC): Urban Institute; 2010.
14. The analysis takes into account the fact that children in families below 138 percent of poverty in separate CHIP programs will move into Medicaid when the Affordable Care Act requirement to provide Medicaid up to 138 percent of poverty goes into effect
15. More about the Urban Institute's Health Insurance Policy Simulation Model and additional details on the methods are provided in the Appendix (see Note 16)
16. To access the Appendix, click on the Appendix link in the box to the right of the article online
17. The preamble of the Internal Revenue Service premium tax credit regulation states that future proposed regulations are expected to rely on the family-based affordability test in applying the individual responsibility requirement to related individuals (see Note 10)
18. Kenney G, Lynch V, Haley J, Huntress M, Resnick D, Coyer C. Gains for children: increased participation in Medicaid and CHIP in 2009. Washington (DC): Robert Wood Johnson Foundation and Urban Institute; 2011.
19. Dorn S, Buettgens M, Carroll C. Using the Basic Health Program to make coverage more affordable to low-income households: a promising approach for many states. Washington (DC): Urban Institute; 2011.