Childrens Health Security Act

1
Childrens Health Security Act

• 2007 Kids Count Conference
• Jim Koppel
• Childrens Defense Fund Minnesota

2
Current Health Care Environment

• Fragmented
• Multiple Public Programs, Employer Based,
  Coverage, Individual Coverage, Uncompensated Care
• Employer-Based Coverage Unaffordable
• Fewer Employers offering coverage
• Passing more costs on to employees
• Cutting back benefits
• Barriers to Public Programs
• Cost
• Administrative (e.g., 36 page application)
• Eligibility (e.g., 4 month waiting period, 50
  rule)

3
Childrens Health Security Act (CHSA)

• Solution for the 85,000 uninsured children and
  tens of thousands more who are underinsured
• Simple
• Affordable
• Accessible
• Comprehensive
• Ensures access to coverage for all children - no
  matter where their parents work or how much they
  earn

4
CHSA How it Works

• Eligibility
• Children ages 0-18 up to age 25 if a dependent
• Phase 1 Raise eligibility from 275 to 300 of
  FPL (approximately 60,000 for a family of four)
• Phase II open program to all children or ensure
  other accessible, affordable coverage for all
  children
• Combine public health care programs
• Remove all barriers and implement best practices
  to maintain coverage, including
• No premiums, co-pays or deductibles
• 2 page application
• Eliminate administrative and eligibility barriers
• 12 month continuous eligibility
• Outreach

5
CHSA How it Works

• Comprehensive benefit set
• Counties contract with managed care organizations
  and/or on a fee-for-service basis
• Families have choice of providers
• Participation in the program is voluntary

6
CHSA Impact on Children

• Universal coverage
• Promotes healthy children and families
• Continuous coverage
• Increased access to primary and preventive care
• Reduce health disparities

Insured children miss less school and perform
better in school than uninsured
children Uninsured children are more than 5 times
as likely to have an unmet medical need than
insured children
7
CHSA Impact Health Care System the State

• Systemic change that will change health care
  delivery system
• Health care system for children like public
  education
• Creates efficiencies by streamlining programs
• Simple eliminates complexity and fragmentation
• Savings
• Eliminate 74 million in uncompensated care
• Hundreds of millions in savings to employers and
  parents

8
CHSA Status

• Introduced each year since 2004
• Strong public education and legislator education
  2004-2006
• Centerpiece of 2007 legislative session

9
2007 Legislative Session

• First bill introduced in the House of
  Representatives
• 65 legislative co-authors
• Passed out of 7 committees
• Passed the full House of Representatives
• Senate included some provisions in its health
  budget bill
• Childrens health coverage centerpiece of
  legislative and public debate
• Resulted in more than 30,000 uninsured children
  gaining access to health coverage

10
Missed Opportunity Systemic Change

• 2007 legislative changes
• Remove some barriers
• Establishes a child-only application (no longer
  than 4 pages)
• Reduce premiums for adults and children
• Outreach
• No structural change in how coverage provided
• System still complicated
• Tens of thousands of children still uninsured and
  underinsured

11
Next Steps

• Continue to work toward passage of full bill
• Continue messaging around access, affordability,
  simplicity and comprehensive coverage for all
  children
• Monitor impact of 2007 legislative changes
• Build on momentum gained over the last three
  years, particularly this past year
• Present CHSA as a model for broader health care
  reform discussions happening in MN