Congress holds purse strong for insurance

hed: Congress holds purse strong for insurance

JACKSON – Already targeted by national child advocacy watchdog groups for dropping thousands of its poorest children from Medicaid health care coverage, Mississippi is now desperately looking to Congress to save SCHIP, its child health care program for working poor families, from drastic cuts or possibly being shut down.

SCHIP (or just plain CHIP, as most know it) is the state Children’s Health Insurance Program, operated separately from Medicaid. Created by Congress in 1998, it now covers 68,000 children of low-income Mississippi families whose employers do not provide medical care coverage or who earn just enough not be eligible for Medicaid.

Medicaid is an entitlement program funded 83 percent by federal dollars that now covers some 605,000 Mississippians (higher three years ago), of whom 130,000 are children, who live below the poverty level (now $40,000 for a family of four.)

On the other hand, SCHIP is a block grant program that depends on federal grants made by Congress on a three-year basis, plus a small amount of matching funds from the state.

Since SCHIP was initiated by Congress as a 10-year program, it must be reauthorized this year and is already embroiled in controversy over a proposed $50-$60 billion expansion of the program sought by a group of Democratic Congressmen.

Formula problems

Meantime Mississippi, along with 13 other states, is facing a shortfall of federal funds this fiscal year because of SCHIP’s existing allotment formula, and needs a bailout of money from Congress now or the programs will be in trouble. Mississippi faces a $12 to $15 million shortfall before the end of the federal fiscal year on Sept. 30.

Advocates say the allotment formula actually penalizes a state such as Mississippi that has high medical costs, low health care workers’ wages, and has been reduced the number enrolled (Mississippi in FY 2006 had 2500 fewer than in FY 2005.)

The Center for Mississippi Health Policy, a non-profit group funded by the Bower Foundation, reported that Mississippi’s FY2006 allotment for SCHIP is substantially below Massachusetts and Alabama, although it has a higher number of children enrolled.

Therese Hanna, executive director of the center showed that Mississippi is allotted $49.9 million for 68,000 children enrolled, while Massachusetts received $59.4 million and Alabama $64.1 million although those states had 4000 fewer enrolled.

Unless the formula is changed by Congress or there is supplemental appropriation, Mississippi could be faced with cutting the number enrolled or reducing services provided.

SCHIP was initially implemented by the state in 1999 using money from the Tobacco lawsuit settlement to fund the state match. Then-Attorney General Mike Moore pushed a public information campaign to inform low-income parents about the brand new program to provide health care for their children. After a slow start, by 2004 the program had reduced the number of uninsured children in the state by half.

A stricter requirement for persons to remain qualified for Medicaid enacted by the Legislature in 2005 at the insistence of Gov. Haley Barbour, had resulted in thousands of children being dropped from Medicaid rolls and losing their medical benefits. It has drawn criticism from national child advocacy groups.

It requires Medicaid parents to be re-certified annually in a face-to-face appearance before a representative of the state agency in order to be eligible for benefits. Critics say many parents find it difficult to leave work in order to meet with a Medicaid agent.

The Lewin Group, a national non-profit health care and human services watchdog body, says Mississippi’s re-certification requirement is the stiffest in the nation and that others allow recipients to enroll either by telephone or the internet.

Funding inside war money

Meantime, $650 million in stop-gap money to cover the SCHIP shortfall in the 14 states that includes Mississippi has been stuck into the supplemental military appropriation for the wars in Iraq and Afghanistan. But as is well-known that measure is caught up in a huge tug-of-war between President Bush and the Democratically-controlled Congress over setting a timetable to withdraw troops from Iraq.

Further down the line is another bill cosponsored by Democratic Sen. Jay Rockefeller of West Virginia and Republican Sen. Olympia Snow of Vermont to fix the SCHIP funding allotment. However, health care for thousands of Mississippi needy children, that many authorities say is the key to breaking the cycle of poverty, hangs in the balance.

Bill Minor is a syndicated columnist who has covered Mississippi politics since 1947. His address is Box 1243, Jackson, MS 39215.