INDIANAPOLIS (Map, News) - An expansion of the State Children's Health Insurance Program that legislators approved last year has won federal approval, making low-cost coverage available to more kids in moderate-income Indiana households - but not as many as once hoped.

A key state lawmaker who welcomed the expansion said the state must find ways to enroll more Hoosiers not only in SCHIP but also in the Healthy Indiana Plan for low-income adults. Rep. Charlie Brown, D-Gary, said lawmakers might take up the matter in summer study committees.

The Family and Social Services Administration last week received approval from the federal Centers for Medicare and Medicaid Services to expand the SCHIP program to children in households earning up to 2 1/2 times the federal poverty level, agency Secretary Mitch Roob said Friday.

Roob said the expansion will bring more than 5,000 children into Indiana's SCHIP program this year and as many as 10,000 eventually.

The poverty level is a sliding scale that includes families of two earning up to $35,000 per year and families of four earning up to $53,000.

The approval came about three months after FSSA formally requested it in late January.

"They really expedited this for us," Roob said.

CMS' speed in granting approval stood in contrast with the caution with which the Daniels administration approached it. After the General Assembly last year passed a bill approving Gov. Mitch Daniels' Healthy Indiana Plan and authorizing an SCHIP expansion to three times the poverty level, CMS denied Indiana's request for that expansion amid a Washington tug of war over the size of the SCHIP program.

Then CMS last August set stringent new eligibility rules for children in homes earning more than 2 1/2 times the poverty level. The state of Wisconsin, which CMS also denied an expansion to three times the poverty level, kept negotiating with CMS and won approval to the 2 1/2 times level last year. Roob did not seek CMS approval for an expansion to the 250 percent level until state Sen. Frank Mrvan, D-Hammond, pressed him on the matter during a State Budget Committee hearing.

"We were waiting for the whole SCHIP debate to occur," Roob acknowledged Friday while crediting Mrvan for turning FSSA's attention to Wisconsin's success.

Brown, who shepherded the health plan bill with its expanded SCHIP coverage to passage in the Indiana House last year, welcomed the CMS approval to 250 percent but said the state has more work to do.

"We still have to ramp up and get more people into the program at 250 percent," Brown said.

He also noted the Healthy Indiana Plan, which can enroll as many as 130,000 low-income adults per year, has drawn applications at a lower pace than some lawmakers had hoped. As of April 23, FSSA had taken 41,017 applications, processed 34,966, and approved just 12,138.

"What is the problem? I think we need to take a look at that," Brown said.

In Indiana, SCHIP is combined with Medicaid to create the Hoosier Healthwise insurance plan for children. The SCHIP portion of Hoosier Healthwise charges monthly premiums ranging from $22 to $50, depending on income and number of children.

Families with children newly eligible under the expansion will need to pay higher premiums. Households earning 200 percent to 225 percent the poverty level will pay $42 per month for one child or $53 monthly for two or more children. Households earning 226 percent to 250 percent of the poverty level would pay premiums of $53 for one child or $70 for two or more children.

Advocate David Roos, of the nonprofit Covering Kids and Families, said Hoosier Healthwise has steadily enrolled more children each month since December, reflecting demand for the subsidized health care. But he said the higher monthly premiums will dissuade some families from enrolling.

Indiana's SCHIP premiums already were among the highest in the nation after the Daniels administration raised them after coming into office in 2005, he said.

"When they raised the premiums before, it dramatically slowed enrollment in that portion of the SCHIP program," Roos said. "We wish they would have kept the premiums as low as possible."

Further impeding enrollment will be new rules affecting only families earning more than twice the poverty level, he said. CMS won't let them use so-called "income disregards" which lower income levels to reflect child support, two working parents and other criteria, much like tax deductions work.

"It's not really as high as 250 percent would have been under the old rules for income disregards," Roos said.

Comments from Examiner Readers

6:01 PM MST on Fri., Jul. 27, 2007 re: "Seniors Have a Stake in Children's Bill"

joseph said:
This bill should be vetoed at the outset; and sent back to the floor for re-reading. It hurts the elderly very much . .robbing grandpa to take care of junior.

55 agree | 64 disagree
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7:29 PM MST on Sun., Jul. 15, 2007 re: "Child Health Insurance Bill Faces Veto"

Knot2brite said:
Why not just put every person in the United States on MEDICARE from birth to death? Get rid of medicaid and simplify all the complex variations of private insurance, Government employee plans, fee for service, co-pays, re-imbursements, and all the other bueatacracy associated with having so many DIFFERENT plans. Just think how much could be saved if the medical billing and insurance beuracracy were somehow brought under control and every American, not just "kids" or "seniors" had a basic level of Health Insurance that was, dare I say, UNIVERSAL? Working people and their employers already contribute 5.4% of an employees earnings for Medicare benefits they MIGHT live long enough to collect. California has the "Healthy Families" program, Medi-Cal AND Cal PERS and other programs and San Francisco now has their version of mandated health insurance for working people. Why so many various "PROGRAMS" instead of a UNIVERSAL Plan?

63 agree | 63 disagree
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