08.28.06

Cantwell Announces Plan to Fight for Expansion of State Children’s Health Insurance Program

70,000 Children Could Receive Coverage; Senators Cantwell, Baucus listen to concerns, ideas from citizens and children’s health experts at Seattle Children’s Hospital

SEATTLE, WA – Monday, U.S. Senator Maria Cantwell (D-WA) announced her plan to provide health care coverage to 70,000 Washington children who are currently uninsured. To date, Washington state has only been able to spend 30 percent of funds allocated through the State Children’s Health Insurance Program (SCHIP). Legislation Cantwell plans to introduce would free up more SCHIP dollars and help states like Washington expand coverage. Of the 100,000 uninsured children in Washington, 70 percent who are not enrolled in Medicaid or SCHIP but are eligible could get coverage under this bill. Cantwell made the announcement at a field hearing she convened Monday with Senator Max Baucus (D-MT) at Seattle Children’s Hospital. Currently, the SCHIP program prevents states like Washington that are leading the nation in providing children with health insurance from using their full SCHIP allotment.

“It’s more important than ever to sustain and expand health care coverage for our children,” said Cantwell. “More families are struggling just to get by and too many families and children go without health insurance, without preventative care, and without the basics like regular checkups at their doctor’s office. Washington led the nation as one of the first states to cover its most needy children. But in other respects, we have tremendous room for improvement, and that’s exactly what we’re here to talk about today at this hearing. This is about keeping children healthy and keeping health care costs down in the long-term. It’s about getting the 100,000 uninsured children in our state covered.”

At Monday’s field hearing, Cantwell focused on improving Medicaid and the State Children’s Health Insurance Program (SCHIP) to deliver health insurance to more children in need. SCHIP, created in 1997, allows states to cover uninsured low-income children from families that have incomes above Medicaid eligibility levels.

When SCHIP was enacted, most states were prohibited from using the new SCHIP funding for children already covered by the state, punishing states like Washington that were already using Medicaid dollars to cover children from families living on income up to 200 percent of the national poverty level. In 2002, Cantwell worked with the Senate Finance Committee to allow Washington to use a portion of its allocation to cover children from Medicaid-eligible families living on less than 200 percent of the poverty level. Before this fix, Washington was only able to use two percent of its SCHIP allotment, and could have been forced to cut coverage for 150,000 low-income children due to rising costs. Thanks to the fix, Washington has been able to spend $112 million—approximately 30 percent—of its $367 million allocation.

To help states like Washington use even more of their full SCHIP allotment and cover greater numbers of eligible uninsured children, Cantwell will introduce legislation allowing states to use SCHIP funds to cover Medicaid-eligible children. This would prevent states from being punished for their own efforts to expand coverage prior to the enactment of SCHIP. Because the federal matching rate for SCHIP in Washington state is higher than for Medicaid—65 percent compared to 50 percent—allowing SCHIP funds to be used to cover Medicaid eligible children frees up more state dollars to expand the number of children covered.

Currently, under SCHIP, individual states can set the upper income level for targeted low-income children from families living on up to 200 percent of the poverty level. In the case of states like Washington where the applicable Medicaid income level for children is at or above 200 percent of the poverty level, the upper income limit for SCHIP benefits may be raised by an additional 50 percentage points above that level. Washington state covers children through its SCHIP program at up to 250 percent of the poverty level—$50,000 for a family of four. There currently are 11,000 children enrolled in the state’s SCHIP program.

Medicaid, created in 1965, explicitly allows coverage of children under age six from families living on up to 133 percent of the federal poverty level. For children under age 19, Medicaid allows coverage up to 100 percent of the poverty level. However, many states have extended coverage well beyond these income levels through the use of program rules, with Washington covering children up to 200 percent of the poverty level. There are 539,000 children covered through the state’s Medicaid program. Nationally, children account for 49 percent of all Medicaid enrollees but just 18 percent of program expenditures.

Monday’s field hearing, titled “The Future of Children’s Health: Road Blocks and Building Blocks in Raising Healthy Kids,” included testimony from local health care experts and citizens, and focused on the State Children’s Health Insurance Program, Medicaid, the challenges of rising health costs, and other public health issues facing children. Diane Rowland from the Kaiser Family Foundation, Washington state’s Medicaid director Doug Porter, Carlo Olivares from the Yakima Valley Farmworkers Clinic, President and CEO of Seattle Children’s Hospital Dr. Tom Hansen, and Liz Arjun from the Children’s Alliance all testified at Monday’s field hearing. Cathy Rigg, the mother of 14-year-old Caity Rigg who suffers from juvenile diabetes, also testified at the hearing on the increasing cost of private insurance coverage.

“Children’s health is about more than whether or not kids have the sniffles. It’s about the fundamental right children have to grow up vibrant and healthy. It’s about making sure kids are energetic and ready to learn, and eventually able to take hold of good jobs, live full and prosperous lives, and help keep America economically competitive,” said Baucus. “Senator Cantwell recently pushed for this reform because she recognizes the urgency of children’s health issues for all of us. I’m grateful that I have a colleague like Maria, who’s so dedicated to keeping our eyes on the ball on issues like child health.”

Baucus is the ranking Democrat on the Senate Finance Committee. The Finance Committee has jurisdiction over Medicare, Medicaid, Social Security, the tax system, and State Children’s Health Insurance Program. At Monday’s hearing, Cantwell also discussed child obesity, diabetes, meth use, health care information technology, and asthma.

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