Restrictions On SCHIP Enrollment Affecting Hispanics In Missouri

Even though many Hispanic immigrants in Missouri qualify for children's health insurance programs such as SCHIP, many remain uninsured, inpart because of concern about their immigration status, as well as federal and state restrictions on their eligibility, the Columbia Missourian reports. Of the nearly three million uninsured Hispanic children in the U.S., 70% are eligible for SCHIP but do not apply because of language barriers or fear of deportation of other family members. Catherine Martarella, a program director for Citizens for Missouri's Children,said, "A mixed-status family, where the child is here legally but the parent is here illegally, is not likely to apply for assistance."

In addition, federal law prevents legal immigrants from applying for federal benefits until they have been in the U.S. for five years. While considering the re-authorization of SCHIP in July, U.S. House lawmakers approved an amendment, known as the Immigrant Children's Health Improvement Act, that would have eliminated the restriction. However,the amendment was not included in the final bill that passed in September, according to the Missourian. President Bush earlier in October vetoed the bill, which would have reauthorized SCHIPand expanded the program to more children.

In Missouri, about20,000 of the 150,000 legal immigrants in the state are children that would be eligible for SCHIP if the rule were lifted, according to Joan Suarez, chair of the Missouri Immigrant and Refugee Advocates.

Missouri Gov. Matt Blunt (R) in 2005 restricted eligibility for the state's version of SCHIP, requiring applicants to show that they could not afford private insurance at a rate 9% lower than the family's income.State lawmakers recently attempted to reverse the restriction and instead require families to prove they could not afford private insurance that is 3% lower than their income. According to the Missourian, enrollment in the state's SCHIP has dropped by 70,000 since 2004.

"Unless we address these barriers, the insurance gap is going to grow,"Jennifer Nu'gandu, senior health policy analyst at the National Councilof La Raza, said. She added, "Congress has an opportunity to come backand rectify the mistake of leaving legal immigrant children out of the health care debate" (Ballenger, Columbia Missourian, 10/22).

Missouri Passes Revised Insure Missouri Program

The Missouri state Senate onMonday voted 30-4 to approve legislation that includes a program to cover 200,000 low- and middle-income state residents, the Kansas City Star reports. The"centerpiece" of the bill is a new version of the Insure Missouriprogram originally proposed by Gov. Matt Blunt (R).

The measure would provide health insurance for people ages 19 to 64 withincomes up to 250% of the federal poverty level. To qualify, state residentscould not have access to affordable employer-sponsored coverage and must havebeen uninsured for at least six months. Deductibles would be based on a slidingscale with a maximum of $1,000 per year. People with incomes lower than 100% ofthe poverty level would not have to pay anything for the program. Employerscould pay up to half of a beneficiary's deductible.

The bill also includes a wide range of initiatives intended to make consumersmore aware of health care costs and to help them make informed decisions. Themeasure would offer a tax deduction for the cost of certain high-deductible insurance policies and encourage health insurers to publicly compare thequality and cost efficiency of health care providers in their networks. Inaddition, the legislation would establish an organization to publicly report onpreventable medical errors at hospitals.

According to the legislation, the program would cost the state at least $40million next year, but the majority of funding for the program would come fromthe federal government and special hospital taxes that would be used toleverage additional federal matching funds. The bill now moves to the House (Wagar, KansasCity Star, 4/28).

Senior, Disabled Missourians Should Sign-Up For Property Tax Relief

Governor Nixon Urges Senior and Disabled Missourians to Sign-Up for Property Tax Relief - The governor pushed for an increase in the property tax break for seniors and the disabled, but many Missourians who are eligible may not be aware they can apply.

Missouri's property tax credit for taxpayers who are 65 and older or disabled has increased this year to a maximum of $1,100, but some could miss out if they fail to apply.

The maximum credit for homeowners grew by $350 and eligibility was expanded to include households with income of up to $34,000 a year.

"I urge more Missourians to apply for the Missouri Property Tax Credit now," said Gov. Jay Nixon, who last year made it a top priority to expand property tax relief for moderate-income seniors and disabled persons.

"Property taxes are skyrocketing across our state, and thousands of Missourians, particularly seniors, are struggling to make payments and keep their homes," Nixon said. "The credit can put money back in seniors' pockets to help them stay in their homes, and it can help other hardworking Missourians."

Who Qualifies

To qualify, at least one person in the household must be 65 or older or totally disabled and total household income cannot exceed these amounts:

$27,500 or less (for renters who are single)
$29,500 or less (for renters who are married)
$30,000 or less (for single homeowners)
$34,000 or less (for married homeowners)

The credit refunds as much as $750 for renters and $1,100 for homeowners and is based on the applicant's income and the amount paid in rent or real estate taxes last year.

How to Apply

To receive relief, senior and disabled Missourians need to apply for the 2008 Missouri Property Tax Credit (formerly called Circuit Breaker).

Free Help with Applications

"Senior and disabled adults can also get free help applying for the credit," said Margaret T. Donnelly, director of the Department of Health and Senior Services. Donnelly was referring to the Volunteer Income Tax Assistance Program (VITA), which provides free tax assistance to low-income, disabled, and homebound taxpayers, and to Tax Counseling for the Elderly (TCE), another free tax assistance program for those 60 and older.

Missouri's ten Area Agencies on Aging are also a good resource for seniors who need help with the property tax credit form.

Anyone who needs free help preparing a state income tax return or property tax credit application can also call one of the Department of Revenue's seven tax assistance centers across the state.

Failing On Medicaid Expansion Bill Missouri Works On Alternative

Affordable health insurance and Medicaid coverage in Missouri suffered a setback as the state house of the representatives yesterday failed to pass the Medicaid expansion bill. Currently the officials are working on an alternative.

The Missouri House on Wednesday rejected a spending bill that would have expanded Medicaid coverage to nearly 35,000 parents, the Kansas City Star reports. Instead, a committee of lawmakers from both chambers of the state Legislature agreed to retain the $146.8 million slated for the expansion and use it for an alternative plan that has not yet been written.

The deal was viewed as necessary so that the budget can pass by Friday as required by the state's constitution (Noble, Kansas City Star, 5/6). According to the AP/Southeast Missourian, the bill failed by an 85-75 vote.

The bill would have expanded Medicaid coverage to custodial parents with incomes of up to 50% of the federal poverty level. Missouri's current income eligibility threshold for the program is $292 per month. According to the AP/Missourian, the agreement gives lawmakers an additional week to reach a compromise on legislation that would expand coverage. The legislative session ends on May 15 (Lieb, AP/Southeast Missourian, 5/7).

Some Benefits for Missouri's New Health Insurance Program Not Funded

Missouri Health Insurance Funding

Some benefits, including dental and vision coverage, included in Missouri's new health insurance plan MO HealthNet were not funded this year, state lawmakers said Tuesday at a forum on health care, the Kansas City Star reports. MO HealthNet, which replaces the state's Medicaid program, took effect on Tuesday, and state lawmakers at the forum answered questions about the new program (Tsai, Kansas City Star, 8/28).

The goal of the $6 billion Missouri health insurance program is to shift the focus of state-funded health care to prevention and early detection of diseases. The program will set up health care homes at existing facilities to serve as a central point of contact for patients and help patients create personalized long-term health plans; restore dental and vision care for Medicaid beneficiaries, subject to funding approval by the state Legislature each year; and restore coverage for up to 13,500 children who were cut from Medicaid two years ago. Premiums for children will be limited to 3% to 5% of parents' annual income.

The program also will create a health program for uninsured women with annual incomes up to 185% of the federal poverty level and raise payments to medical providers up to the federal maximum within four years (Kaiser Daily Health Policy Report, 7/5).

Missouri state Rep. Mike Talboy (D) said a provision that would require beneficiaries to meet "healthy living benchmarks," such as maintaining a healthy weight, to receive dental and vision benefits was removed from the final version of the legislation. However, state Rep. Beth Low (D) said, "The reality is there is no real health insurance coverage for dental care and vision." State Rep. Paul LeVota (D) said advocates must continue to push for changes to the state's health care system. LeVota said that even though lawmakers next session might make it sound like "we're already done with that and we've fixed health care, don't let this issue die" (Kansas City Star, 8/28).

Missouri Health Insurance Legislation Replacing Governor's

Missouri Republican House leaders have introduced legislation that would expand health coverage to low-income state residents and require beneficiaries to contributemoney to savings accounts to use toward deductibles and copayments, the St. Louis Post-Dispatch reports. The proposal, called"Insure Missouri,"is intended to replace a proposal of the same name by Gov. Matt Blunt (R). Blunt'sproposal failed to garner enough support among lawmakers.

Under the Republican proposal, individuals with annual incomes less than 85% ofthe federal poverty level would be eligible for coverage. Eventually, theincome threshold could reach 225% of the poverty level. Beneficiaries would usea state Web site to purchase individual insurance policies with a set packageof benefits. People who were denied coverage by insurers would be able toparticipate in a high-risk pool. The state would pay the premiums.

Beneficiaries also would be required to contribute 1% to 5% of their annualincomes, based on a sliding scale, to a savings account to pay deductibles andcopays. Those who do not comply with the savings component would lose coverage.Deductibles could be as much as $2,500. The first $300 in preventive healthcare and two doctor visits would not be subject to deductibles or copays. The bill also would call for changes to the certification process for new medicalfacilities and enforce a price transparency mandate.

The proposal initially would cost the state an estimated $46 million and expandcoverage to an additional 77,000 state residents (Young, St. Louis Post-Dispatch, 4/7).

Health Insurance Must Cover Autism Says Missouri Governor

Governor Jay Nixon is asking House members to follow the lead of the state Senate and pass a bill that requires health insurance coverage of autism. The Missouri House members turned down the bill earlier this year.

According to the Kansas City Star, Governor Nixon is pressing for a bill that guarantees health insurance providers “will cover the most effective treatments for autism” and that includes “substantial provisions that make real differences for real families.” Governor Nixon has been traveling around the state making his case, appearing at an autism clinic affiliated with the University of Missouri, Children’s Mercy Hospital in Kansas City, and an autism center in St. Louis.

According to a study called “Missouri Public Schools Autism Prevalence Report 1992 - 2003,” Missouri had 2,863 cases of autism in children in 2003. This is an underreported figure, however, because it does not include children who attend private schools or who are home taught, those who do not meet the eligibility criteria for the autism disability category, or those who are in regular education classes. Therefore the actual number of autistic children who would be covered by health insurance could be much higher.

This fall, Senators Scott Rupp (R-Wentzville) and Senator Eric Schmitt (R-Glendale) plan to introduce legislation. Senator Rupp introduced an autism health insurance bill that passed in the Missouri Senate in May, but the bill was prevented from reaching the floor of the House. Senator Schmitt has a child with an autism spectrum disorder.

Governor wants to see four elements in an autism health insurance bill: carriers must cover the diagnosis and treatment of autism, coverage must include specific therapies, and the minimum cap on benefits must not be less than $35,000 per year; no limit on doctor visits; and insurance carriers cannot refuse or terminate coverage because of an autism diagnosis. Health insurance companies claim that requiring coverage of autism will raise insurance premiums for all of their customers.

Representative Ron Richard (R-Joplin), who was largely responsible for preventing last year’s bill from reaching House vote, has changed his colors. This year, Rep. Richard created an independent Autism Spectrum Disorder Interim Committee that is charged with crafting a House version of the bill. The true test will take place this fall when the Missouri lawmakers return to once again hash out health insurance coverage legislation for autism.

SOURCES:
Kansas City Star 8/6/09
Missouri Public Schools Autism Prevalence Report 1992 - 2003

MO Health Insurance Goes Social with Healthychat.com

Missouri health insurance provider, Anthem BlueCross BlueShield, has created an online forum, Healthchat.com, to address concerns from Americans over the impact of health care reform. The health insurance provider is also taking advantage of social media to get the job done.

With the use of the website, Twitter, Facebook, and YouTube, Anthem BCBS hopes to reach those who have questions about how the health insurance reform will impact them personally. The text of the law is long and complicated, making it challenging for citizens to learn how each will be individually affected. Kate Quinn, of Anthem, says, “By offering a forum on healthchat.com, we are providing an interactive place where consumers can participate in an open discussion about health benefits and the impact of health care reform.”

Healthychat.com has two main areas: Learn and Stay Informed. On the Learn page is where the “interactive” discussion board is located. Also given are blog posts with information such as “Is it safe to get immunized when pregnant” and others.

Users create a profile, similar to those found on Facebook, Twitter, and other social media sites in order to register. They can keep track of conversations, create favorites and make connections with others. And users can “Stay Informed” with a blog at healthychat.com which offers information on upcoming features and related news stories.

Right now, there does not seem to be an interactive quality as reported, upon use of the site. There is a lot of information there but it is not easily clear how one can interact with the site beyond reading the information. Users can comment upon the articles and topics that are there but there does not appear to be a way to start a conversation. Users can “suggest” a topic, however. They can also add the topic discussions to favorites and share it on other social media sites. It causes one to wonder how this website is any different than any other health insurance news website.

The difference may just be that Anthem is listening. The company has created a Twitter account, a Facebook page, and a YouTube channel to complement the healthychat.com website. Employees from the company monitor the conversations and use that to provide feedback to the general public and to incorporate suggestions into the website as well as its own policies. At the very least, it is an informative website.

Missouri Plan To Help Low-Income Workers Obtain Insurance

Missouri Gov. Matt Blunt (R) on Tuesday announced a three-phase planto help low-income workers obtain health insurance through governmentsubsidies, the Kansas City Starreports. The proposal aims to extend coverage within a year to 131,500working adults with incomes up to 185% of the federal poverty level.

Under the plan, the state in October would seek bids from private insurers to provide coverage, according to Amy Blouin, executive director of the Missouri Budget Project.In the first phase, Medicaid would provide health coverage for custodial parents with incomes up to the poverty level, and benefits would be similar to those provided to state workers. Families within comes below the poverty level would not contribute premiums and would be charged co-payments ranging from 50 cents to $3 per service.

In the second phase, Medicaid would pay for coverage of working adults with incomes up to 185% of the poverty level. Those adults would be required to contribute higher co-pays and premiums, but total contributions would not exceed 5% of the person's income.

Under the third phase, which is scheduled to be implemented by early 2009,the state would provide catastrophic coverage for employees of businesses with 25 or fewer workers. Eligibility would be limited to workers with incomes of no more than about 250% or 300% of the poverty level. The plan requires approval from the state Legislature and the federal government.

Funding

The plan would be funded by a combination of state taxes, special Medicaid taxes, federal money hospitals receive for providing indigent care and federal matching funds. Steve Renne, deputy director of the state's Department of Social Services,said the program is expected to cost less than $50 million from February 2008, when it begins, through June 2008, when the fiscal year ends. The program is expected to cost $631 million annually by 2010.State contributions would be capped at $46.8 million, while other contributions would increase, according to Renne (Wagar, Kansas City Star, 9/18).