CHIP Program Success and Future Strategies in Utah

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