Health Coverage Expanded

By KIT WAGAR
The Star’s Jefferson City correspondent

Missouri officials filed regulations Thursday that soften last year’s health-care cuts by allowing more families to qualify for state-funded health coverage for their children.

The Department of Social Services estimated that the change would allow 5,418 children who were dropped from the program last year to become eligible again.

Gov. Matt Blunt said he directed the department to make the change to expand access to health care and make the Children’s Health Insurance Program more equitable and affordable for moderate-income families.

The program, known as CHIP, is an extension of the state’s Medicaid program that offers health coverage for children in families that earn too much to qualify for Medicaid. A year ago, before the Medicaid cuts took effect, CHIP covered 93,730 Missouri children from families with income up to three times the federal poverty level.

But last year, the legislature, as part of the restructuring and downsizing of Medicaid, instituted monthly premiums for all participants in CHIP with income of more than 150 percent of the poverty level. The law disqualified families if the parents had access to “affordable insurance.”

It defined affordable as less than $342 a month. That amount was scheduled to increase to $375 next month.

The new regulations, which take effect July 1, attempt to set the affordability level at roughly 9 percent of the income of a family of three. It would lower the affordability level for most families in the program to $209 or $255 a month.

In January, Joel Ferber, who handles health issues for Legal Services of Eastern Missouri, published a study that blamed the current affordable insurance rule for many children losing insurance.

A single mother making $20,000 a year could insure her child through CHIP for $17 a month. But she would be disqualified if her employer offered insurance that cost anything less than $375 a month.

The program, therefore, expected her to put out 23 percent of her income for private insurance before turning to a state program. It essentially rewarded people for earning less or for taking jobs that offered no health insurance.

Because the poverty level rises with family size, smaller families would be expected to pay a larger percentage of their income than large families. For example, that single mother with one child would be disqualified if she could buy insurance for less than $209 a month, or 13 percent of her income.

A family of five could qualify with income of $35,200 if insurance was not available at the same $209 a month, or 7 percent of the family’s income.

Deborah Scott, spokeswoman for the Department of Social Services, said officials tried to craft a system that was fair. To be equal at every income level would require a complicated graduated scale and the statute is not written that way, she said.

“This is a vast improvement over the previous system and makes insurance more available to more children,” Scott said.

The change is expected to cost state taxpayers about $1.8 million a year.