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States Promoted Broader Coverage for Children in 2007, But Report That a Declining Economy Coupled With Lack of SCHIP Reauthorization and New Federal Rules Now Compromise Efforts to Reduce the Number of Uninsured
Date:1/28/2008

reauthorization of the SCHIP program and with a new federal directive restricting states from using SCHIP to cover children in families earning more than 250 percent of the federal poverty level, these state efforts could be compromised. Twenty-three states could be affected by the directive, including 14 which have already implemented their plans and another ten which have authorized the plans into law, but not yet implemented them. (Washington state is counted in both categories.) Three states have already cut back on their coverage. States also continue to report that the Medicaid citizenship documentation rule is hampering efforts to simplify enrollment and resulting in delays and denials of coverage.

A second report released was based on a November 2007 discussion with ten leading Medicaid directors, representing all regions of the country, who warned that with increasingly poor economic conditions, state Medicaid programs will be stressed. Given earlier efforts to minimize Medicaid spending, the officials noted that achieving significant Medicaid cost savings could be more difficult than in prior years. Virtually every state has already taken cost control actions on prescription drugs and provider payments. Additional action in these areas would yield minimal additional savings and could impact access to care, according to the Medicaid directors. The directors also expressed concern over growing strain in their relationship with the federal government and federal rules on health coverage and services issued over the past year that will restrict federal Medicaid financing, which they believe will adversely affect beneficiaries and safety net providers as they struggle to cope with the economic downturn, and create impediments to effective program design. The directors criticized the timeliness of annual changes in the federal matching rate for Medicaid funds as not responsive to changing economic conditions.

The reports released today include
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SOURCE Kaiser Family Foundation
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