Colo. Children’s Health Advocates Eye SCHIP Debate

Colorado advocates for a key children’s health insurance program are closely watching the debate in Washington this week over its reauthorization. Democrats and Republicans in Congress are fighting over how much money to give the State Children’s Health Insurance Program (SCHIP), which provides health coverage to children whose families don’t qualify for Medicaid but cannot afford private insurance.

The program, called CHP+ in Colorado, provides coverage for more than 56,000 children and 1,200 pregnant women in the state. If the federal program is not reauthorized by the Sept. 30 expiration deadline, all of those covered stand to lose their benefits. But because the 10-year-old program has been popular on both sides of the aisle, that’s not likely to happen, experts say.

continued…If lawmakers can’t pass reauthorization legislation on time, they’re likely to temporarily extend the program at its current funding level, says CHP+ director Bill Heller.

“Even if they continue on with their fight, they’re not going to leave us hanging,” Heller said.

CHP+ is funded by both state and federal dollars, and Colorado receives an approximate 2:1 match of federal to state money. This year, Colorado received $71.5 million from the federal government for CHP+, but will likely return some of that eventually. That’s because unused SCHIP money must be returned to the federal government after three years, and Colorado regularly doesn’t spend all of its annual allotment.  SCHIP grants are allotted based primarily on the number of eligible, uninsured children in each state, and about 41,000 eligible children in Colorado have not signed up for CHP+. The extra money that would have gone to help cover those children is redistributed by the federal government to states with funding shortfalls.

But, after a budget-crisis-induced enrollment freeze for CHP+ in 2003, Colorado has renewed its outreach efforts to enroll more eligible children. As enrollment in CHP+ rises, so does the state’s spending of federal SCHIP dollars.

Advocates in Colorado worry that if Congress doesn’t reauthorize the program with enough money, CHP+  could hit a funding shortfall in a few years.

Heller estimates the state would spend its entire allotment of SCHIP money by 2010 if the program were funded at its current level. That would mean some children eligible for the program could not be enrolled.

All the SCHIP reauthorization proposals being considered in Washington would expand funding for SCHIP, but several of them don’t go far enough, advocates say.

“We’ve got to ensure there’s enough funding to cover the children who are eligible but are not insured,” says Edie Sonn, communications director for the Colorado SCHIP Coalition, an advocacy organization whose 30 members include the Colorado Hospital Association and the Colorado Fiscal Policy Institute.

President Bush has called for an additional $5 billion for the program over five years, and House Republicans unveiled a plan last week that could add as much as $10 billion. But the non-partisan Kaiser Commission on Medicaid and the Uninsured estimates an additional $13 billion to $15 billion is needed to maintain current enrollment levels.

President Bush has threatened to veto a bipartisan $35 billion proposal in the Senate and a Democratic $50 billion proposal in the House. Votes on both proposals could come as early as this week.

Colorado Democrats Sen. Ken Salazar and Rep. Diana DeGette, both of whom sit on key committees considering the legislation, have been vocal proponents of higher federal funding for SCHIP. But Republican Sen. Wayne Allard supports Pres. Bush’s plan and says Democrats are trying to expand SCHIP beyond its original intent of providing health coverage to low-income children.

Already some states have raised income limits and expanded eligibility for SCHIP programs to adults. Funding the program at a lower level, some Republicans say, would force states to tighten requirements and limit coverage to children under 200 percent of the federal poverty level.

Most of Colorado’s eligibility requirements would not likely change with less funding, but any talk of expanding the program would have to be re-evaluated.

For example, several of the health care reform proposals being considered by Colorado’s 208 Commission would expand CHP+ eligibility with the intent to maximize use of federal matching dollars. But if those dollars aren’t available, the state would have to find the money somewhere else — although that’s only if SCHIP reauthorization allows states to continue to control eligibility requirements.

One way or another, the outcome in Washington will affect the CHP+ program in Colorado.

“We want to see something happen so we know how to manage our program and get ready for what’s coming,” Heller said.

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