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CHIP Children's Health Insurance Program

CHIP Children's Health Insurance Program. Success! Now What’s Next? Nate Checketts Utah Department of Health. Utah’s Program. Separate CHIP program Coverage up to 200% Federal Poverty Level – ($44,100 for a family of four)

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CHIP Children's Health Insurance Program

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  1. CHIPChildren's Health Insurance Program Success! Now What’s Next? Nate Checketts Utah Department of Health

  2. Utah’s Program Separate CHIP program Coverage up to 200% Federal Poverty Level – ($44,100 for a family of four) Services and copayments benchmarked to private health insurance plan Quarterly premiums up to $75 per family 40,449 children enrolled (almost 5% of all Utah children)

  3. Another Option for Families • Utah’s Premium Partnership for Health Insurance (UPP) • Provides premium assistance for CHIP eligible families that enroll in their employer sponsored insurance • Pays up to $120 per month per child, parents can receive $150 per month subsidy from Medicaid funds • Covers nearly 500 children (over 1% of CHIP eligible kids) • Will coordinate with new exchange policies (1/1/2010) • Expecting federal approval to subsidize COBRA coverage, have requested the ability to subsidize non-group policies

  4. Enrollment Efforts • Closely coordinated with Medicaid • Same administrative agency • Same eligibility system and workers • Same applications • Covering the Uninsured – Enrollathon with local TV station • Robert Wood Johnson Foundation’s Maximizing Enrollment grant – identify and eliminate administrative barriers • Providing families with options – CHIP vs. UPP

  5. CHIP’s Success • State flexibility has been key • Individual state programs have been tailored to local conditions and better meet the needs on the ground • In Utah, CHIP has strong public perception (72% positive rating in opinion poll vs. Medicaid’s 54% rating) • Many families have asked to be put on CHIP instead of Medicaid: • Less stigma (CHIP is for “working” families) • Better access to services

  6. CHIP Reauthorization Act • Provided states with a significant increase in funding • Created performance bonuses • Expanded express lane options • Instituted new mandates that made CHIP look and act more like Medicaid rather than private insurance • Managed care • Special payments for federally qualified health centers • Mental health parity • Dental services

  7. Health Care Reform • Individual requirement for coverage would increase participation in public programs • Expansion of Medicaid is cheap, but comes at a cost – low reimbursement rates often mean low provider participation • Proposals to eliminate CHIP would remove states’ unique programs • National exchange could crowd out state exchanges that are just beginning to explore critical issues • Minimum benefits • Employer participation requirements • Subsidies

  8. Other Options for Reform • State option to simplify income standards for Medicaid • State option to move children into the exchange on the state’s own schedule, allow continuation of premium assistance options to ease conversion • Expand CHIP-like product to new groups, not Medicaid • All pregnant women, children, parents, and adults without dependent children on CHIP-like product • Elderly, blind, and disabled on Medicaid/Medicare

  9. CHIPChildren's Health Insurance Program Nate Checketts CHIP Director Utah Department of Health 801-538-6043 nchecketts@utah.gov

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