State of Iowa facing millions more in costs while kicking 44,000 children off health insurance
DES MOINES – Iowa’s outstanding health insurance for children is at risk due to the Congressional failure to reauthorize the Children’s Health Insurance Program (CHIP). Without federal action, the state of Iowa faces millions more in costs even though 44,000 fewer children would be insured.
State Senator Nate Boulton of Des Moines, a board member for Iowa’s nationally praised hawk-i children’s health insurance program, called for “swift, firm, united action” after the organization’s Monday board meeting.
“This crisis affects families in every county of this state. This is an ‘all hands on deck’ moment for Iowa’s elected leaders,” said Boulton. “In January, the Legislature should immediately approve a resolution officially requesting that Congress reauthorize the Children’s Health Insurance Program. Then, we should all be urging Governor Reynolds to travel to D.C. to make that case to the House, the Senate, and President Trump.”
On September 30th, Congress failed to reauthorize CHIP for the first time in the nearly 30 years of the program’s existence.
There are two components to hawk-i, Iowa’s version of CHIP. One covers the 16,000 Iowa kids enrolled in Medicaid expansion. They are the lucky ones in that they will continue to have health insurance for at least the next two years. However, without a federal reauthorization of CHIP funding, Iowa’s state budget will be required to cover the shortfall. That will mean additional costs of $10 to $15 million per year to Iowa’s already troubled state budget.
Things are much worse for the 44,000 Iowa children enrolled in Iowa’s nationally-recognized hawk-i program. Those children will lose their health insurance completely when funding runs out, something that is expected to happen this February.
“We need swift, firm, united action to prevent a children’s health care crisis in Iowa,” Boulton said. “It’s this simple: If CHIP isn’t reauthorized, 44,000 fewer children in our state will have access to the high quality health care hawk-i provides.”
Iowa Pediatrician Amy Shriver, MD, and State Senator Janet Peterson support allowing parents unable to buy insurance on the individual market to buy into hawk-i, Iowa’s children’s health insurance plan..
July 24, 2017 (Des Moines) Today at the Iowa Statehouse, a state senator and an Iowa pediatrician proposed a plan to protect more than 11,000 Iowa children from losing health insurance on January 1 of next year. The children’s parents are among those who would lose all access to health insurance if the individual market in Iowa collapses or the policies in the individual market are not affordable.
“There is a very real possibility that 72,000 Iowans could be without health insurance next year. Governor Reynolds should immediately ask the Trump Administration to allow Iowa families to purchase health insurance for their children through hawk-i, Iowa’s children’s health insurance program,” said State Senator Janet Petersen of Des Moines. “This is a simple, affordable and straightforward solution that would give thousands of Iowa families the certainty that health care will at least be there for their children.”
Hawk-i provides health and dental insurance to children aged 18 and under from lower income families. Parents pay premiums on a sliding scale and the rest of the costs are picked up by the state and federal government. The program was established with strong bipartisan support in 1999. Iowa’s program has earned widespread praise for providing high quality care, being easy to use, and having low administrative costs.
Under the proposal, Iowa families unable to purchase health insurance elsewhere could buy insurance for their children through hawk-i. Parents would pay the full cost of the premiums, which are expected to be affordable due to the relatively low cost of insuring children.
“We already collect premiums based on a family’s ability to pay,” said Petersen. “We aren’t asking for additional federal or state dollars to make this plan happen. All we need is the federal government’s permission to allow Iowa parents to buy into hawk-i.”
Dr. Amy Shriver, a Des Moines pediatrician, said: “Access to healthcare, including oral care, is essential to children’s healthy development and future success. Children learn best when they are healthy and safe. Children need regular, preventive well-child checkups.”
Petersen’s experience with these issues includes her past service on the hawk-i Board of Directors and years of experience working with insurance issues as a leading member of the Iowa Senate’s Commerce Committee.
“Iowa families on the individual market are small business owners, self-employed, or work for organizations that don’t offer group plans. They are just a few short months away from losing their health insurance and are without affordable alternatives. With no sign of a viable solution coming from Congress, we need Governor Reynolds to act,” said Petersen. “Governor Reynolds, please ease these parents’ fears. Use your power to push for a solution Iowans can actually afford – especially for our kids.”
Summary: Keeping Iowa’s Kids Insured
Background:
Iowa has consistently ranked in the top states in the country for children’s access to health care and dental care.
Iowa’s Children’s Health Insurance Program provides coverage to over 60,000 children.
The covered services under hawk-i are approximately equivalent to the benefit package of the state’s largest HMO at the time the program was initiated.
Providing medical care through health insurance that includes essential health benefits is less costly, produces better results, and helps prevent unnecessary, costly visits to emergency rooms.
The threat to health care coverage for more than 11,000 Iowa children:
It is possible that Iowa will have no insurance plans available in the 2018 individual market. Wellmark and Aetna have already dropped out. Medica intends to stay in the marketplace and has requested a 43% rate increase. There is no guarantee Medica will not back out later.
Iowa’s Insurance Commissioner has responded to the problems with the individual market by with a “Stop Gap Proposal” that is pending with CMS. The “Stop Gap Proposal” would use the federal funding that today provides ACA subsidies and cost sharing reductions to allow Iowans to purchase a public option plan, similar to a silver level ACA plan. This plan will be available for purchase to all Iowans, some with a subsidy. Families earning more than over 400% of the federal poverty level would not be eligible for a subsidy.
Both options under the “Stop Gap Proposal” will be very expensive. With Medica’s premiums going up 43%, many families will not be able to afford the plans, even if they get a subsidy. can only buy into the program in January and must stay in all year to remain eligible.
The Iowa Senate Democrats’ Expanded hawk-i Proposal: Making sure more than 11,000 kids have health care
More than 11,000 Iowa children receive their insurance coverage through an individual market plan purchased by their parents. They will not have access to health care if their parents cannot afford to buy a Medica or Stop Gap plan or the plans are not available.
In order to keep children insured, it is proposed to allow parents to buy into the hawk-i plan for their children ages 18 and below. It could also cover children up to age 26 as all private plans must currently do.
Expanded hawk-i would be available to families with incomes above 300% of the federal poverty level. (Those below 300% are already eligible for hawk-i.)
Conclusion: Governor Reynolds should ask CMS for emergency approval to allow Iowa parents with incomes over 300% of the federal poverty level to purchase, without subsidy, hawk-i coverage for their children. These families may be without any other options in Iowa in 2018.
