California Considers Freeze On SCHIP Enrollment To Prevent Current Beneficiaries From Losing Coverage

Main Category: Medicare / Medicaid / SCHIP
Article Date: 18 Nov 2008 - 7:00 PDT

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California officials are considering freezing enrollment in the state's Healthy Families program, as an "influx of new clients overwhelms" it, the Los Angeles Times reports (Rau, Los Angeles Times, 11/14). The program is facing a $17.2 million deficit that could lead to children losing their coverage if not addressed. Healthy Families is the state's version of SCHIP and provides medical, dental and vision coverage to more than 900,000 children in the state. New enrollment in the program has averaged more than 27,000 per month during the past year.

Lesley Cummings -- executive director for the state's Managed Risk Medical Insurance Board, which administers Healthy Families -- has told the board that the only way to manage costs for the program and avoid cutting benefits to children is to limit or freeze enrollment. She also said that such a freeze was set for Dec. 18 by the state budget. According to Cummings, the only step that could avoid a freeze in enrollment is "more dollars to make up the shortfall" (Rojas, Sacramento Bee, 11/14). Cummings said, "If the board does not cap enrollment, it would have to take other, more drastic actions later," adding, "Capping enrollment, rather than eliminating coverage that a child currently has, seems the preferable path" (Los Angeles Times, 11/14). Advocates for children say as many as 162,000 eligible children could be on the wait list by June 2009 if a freeze is enacted.

State Sen. Darrell Steinberg (D), who will take over as the Senate president pro tempore on Dec. 1, said children's health care should remain a top priority despite the state budget crisis. California faces an $11.2 billion deficit for the current fiscal year. He said, "I would urge [MRMIB] to hold up on such a vote." Steinberg said he has spoken with officials for other state-funded programs and foundations "about stepping up." He also said President-elect Barack Obama has proposed increasing SCHIP funding. Cummings said that the new administration's support for SCHIP is encouraging but added that the state would have to put up matching funds. California pays $1 for every $2 spent by the federal government on Healthy Families (Sacramento Bee, 11/14).

Cummings' recommendation will be discussed at an MRMIB meeting Wednesday. The board is expected to vote on Dec. 17 on whether to freeze enrollment the next day (AP/San Francisco Chronicle, 11/13).

Editorial
"Alternatives exist" to freezing Healthy Families enrollment, a San Jose Mercury News editorial states. According to the Mercury News, California Gov. Arnold Schwarzenegger (R) "could justify more money for Healthy Families because for every $1 the state invests, it gets $2 in federal funds." In addition, an "increase in the tobacco tax, which [Schwarzenegger] supported in the past, could support the program," the editorial states. The Mercury News writes, "Schwarzenegger thinks comprehensive health care reform will solve this problem, but getting this done anytime soon is a delusion," adding, "It's a cop-out, just as thousands of more families are losing employer-based insurance" (San Jose Mercury News, 11/16).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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