Insurance for poor may go up

By Michele McNeil

michele.mcneil@indystar.com



Thousands of Hoosier families too poor to afford regular health-care coverage may have to pay twice as much to enroll their children in a taxpayer-funded health insurance program.



The state is proposing to double the monthly premiums families pay to be part of the growing Children's Health Insurance Program, called CHIP. The increases, the first in five years, come as state officials try to deal with escalating health-care costs and the growing number of children who need insurance.



The monthly premiums for the program, which provides medical, dental and vision insurance for nearly 20,000 children, are based on a family's income and number of children.



Families now pay from $11 to $24.75 a month. If the changes are approved, the monthly premiums would be from $22 to $50.



The state will hold public hearings on the issue in September. The premium increases likely wouldn't take effect until Jan. 1.



The changes do not affect the children on Medicaid whose families pay no insurance premiums.



By charging more, the state would generate $2 million for the program.



Indiana spends about $80 million a year in state and federal money on the children's health program, which has grown from serving 12,695 children in 2002 to nearly 20,000 today.



That's about all the state can afford to spend, says program Director Ann Alley.



Not only are more children enrolling in the program, the cost of health care continues to increase.



Dental services, especially, are expensive, she said. In 2004, the state spent $3.1 million on dental services, more than it spent on prescription drugs or hospital stays.



Alley said raising monthly premiums is a better option than trying what other states are doing, such as limiting the number of people who can get help or scaling back benefits.



"We just didn't want to do that," she said. "I'm hoping we don't have to raise premiums again. In fact, I'm hoping we can lower them at some point."



While increasing premiums can save the program money, a 2004 study by the National Academy for State Health Policy warns that more families won't be able to participate.



As income fluctuates, children may come on and off the program -- interrupting their medical care.



In addition, the study notes there can be political consequences to kicking children off health insurance, and that 32 states have created new fees or raised fees in the past three years.



The premium increases won't stop most families from participating, said Elaine Zeider, who works for the Area Five Agency in Cass and Fulton counties, helping to enroll families in state health programs.



"For $50 a month, you get everything -- medical, dental and vision," said Zeider, who said that's a much cheaper option for families who lose their insurance and can't afford private coverage. "Most will continue paying those premiums because of the services."