By Cody Belzley
In December the U.S. Department of Health and Human Services once again recognized Colorado as a national leader in providing health coverage for kids. For the third year in a row, Colorado was awarded a bonus payment for efforts to make public coverage programs—Medicaid and CHP+—work better for Colorado kids and families. The national recognition is nice—and the accompanying $43 million payment to the state certainly doesn’t hurt—but it isn’t a reason to rest on our laurels and call the job done.
We still have about 120,000 uninsured kids in our state. But the momentum is in our favor. Covering all Colorado kids is within reach, if we’re willing to invest the resources— time, money and political capital—to do it.
Here are four key steps legislators and administration officials can take in 2013 to demonstrate their continued commitment to health care coverage for kids.
First, approve the Medicaid expansion made possible under the Affordable Care Act. We already cover kids to 133 percent of the federal poverty level, so this expansion is not about new eligibility for children. However, we know that of the 120,000 uninsured children in our state, just more than 80,000—nearly 70 percent—are currently eligible but not enrolled in Medicaid or CHP+. One proven strategy for getting kids covered is to cover their parents. The Medicaid expansion will provide coverage to more than 22,000 parents, which we know will translate to coverage for more children. Additionally, the expansion will make Medicaid accessible to more than 100,000 other adults, many of whom are aunts, uncles and grandparents, teachers, coaches and mentors who support the healthy development of children every day. This expansion supports a culture of coverage where health care is the norm for everyone, including low-income, working people.
Second, continue to streamline and simplify the application, enrollment and re-enrollment processes for Medicaid and CHP+ so families can more easily access the services they need to stay healthy. Colorado has made tremendous strides in this area and should be very proud of that progress. The online application system PEAK makes the process much more accessible and investments in the Colorado Benefits Management System are beginning to pay off in terms of more timely and accurate application processing. That said, this is an area where Colorado has historically struggled and we’re still far from where we should be. Continued vigilance is needed. There are specific opportunities for improvement here, including:
- Simplifying client correspondence generated to communicate with families about their enrollment status and how to use their health benefits.
- Adequately training and supporting county and community partners who process applications.
- Expanding the number of community-based partners throughout the state who do outreach to educate families about public coverage options and assist in the application process.
Third, take steps to ensure that once kids get covered they stay covered. Sometimes referred to as “churn,” there is an all-too-common phenomenon of families cycling on and off Medicaid as their income fluctuates due to seasonal work and other temporary changes in income and life circumstances. This disrupts care for kids, creates administrative burdens for health care providers and is inefficient and costly for the state. In 2009, the hospital provider fee authorized the state to implement a policy of 12-month continuous eligibility for children on Medicaid. This would mean that a child who qualified for Medicaid could stay on the program for 12 months, regardless of changes in the family’s income. We have a similar policy in place for CHP+ today. For various reasons, this policy has not been implemented, but the time has come to do so. No more excuses— we need 12-month continuous eligibility for children in Medicaid in 2013.
Finally, ensure the Colorado Health Benefit Exchange is in a strong position to serve all families, particularly low-income families who may be shopping for health insurance for the first time. Coloradans should be incredibly proud of the bi-partisan, cross-sector effort to establish the exchange. The staff, board and legislative review committee of the exchange have done heroic work thus far to prepare for the launch of the exchange this fall. As a result, Colorado is far ahead of most states in providing this point of access to coverage. But the effectiveness of the effort will be best measured by the experience of those who use it to buy insurance. And we have to be particularly mindful of the unique needs of families who will be first-time shoppers for insurance, those who will have kids on CHP+ and parents on subsidized private coverage in the exchange and families that will move back and forth between Medicaid and subsidized coverage. Serving these families will be complicated and hard and we need to ensure we have the resources available and systems in place to do the job well.
Ensuring evall children can get the care they need, when they need it is not too much to ask. Getting all kids covered is the first step to ensuring access to reliable, high-quality and affordable care they need to grow up healthy and strong. We have made great progress in Colorado over the last five years and with continued investment, we can finish the job.
Cody Belzley is vice president of health initiatives for the Colorado Children’s Campaign.