Even as federal Medicaid funds through the stimulus package dwindle, experts and state officials are collaborating on ways to identify and enroll eligible children in CHIP and traditional Medicaid this year. They are also working on similar strategies to target the millions of adults who will become eligible for Medicaid in 2014. Kaiser Health Network recently interviewed three health policy analysts for their take on how states can bring the nearly 5 million eligible but unenrolled children into the Children’s Health Insurance Program. The experts from the National Academy for State Health Policy, the Center for Children and Families at Georgetown, the Kaiser Family Foundation, and the Center on Budget and Policy Priorities enumerated several strategies states could adopt.

First, simplify Medicaid enrollment by giving states the option to enroll children automatically based on their records with other government agencies like those that administer food stamps or subsidized school lunch programs. In early 2010, Louisiana identified nearly 10,000 children via its food stamp program who were eligible for CHIP or Medicaid by not enrolled. Express lane eligibility could be expanded by developing a joint Medicaid/CHIP online application which eliminates the now-mandatory in-person interview. This expedited process is currently allowed for enrolling children under a 2009 federal law and 18 states already use it as an option. Federal law could further be changed to allow express lane enrollment for adults, especially those who will become Medicaid eligible in 2014. Creating an express lane process which applies to all Medicaid eligible individuals would encourage enrollment by lowering the barriers to entry. Eligibility terms could also be increased from 6 months to 1 year, and the process for renewing Medicaid coverage could be streamlined.

New Strategies Employed to Enroll More Children & Adults in Medicaid

States might also consider eliminating the asset test applied when determining adults’ Medicaid eligibility. This test has already been dropped for parents enrolling their children in most states. One big barrier to enrolling more of the Medicaid eligible population is the social stigma associated with being on Medicaid. Unfortunately, this stigma places Medicaid enrollees in the same category as welfare recipients. Though both these programs provide necessary services to families in need, “welfare” has taken on a negative connotation in popular culture, one which Medicaid has also acquired. In order to encourage a culture of coverage, states could rename Medicaid to something more appealing and which sounds less like a welfare entitlement. My home state of Connecticut already made such a change, renaming CHIP the “Husky” Program after our NCAA Champion UConn basketball teams.

Finally, experts suggested paying incentives to nonprofit social service agencies who help enroll children in Medicaid and CHIP. Some states including Oregon, California, Louisiana, New Hampshire, Illinois, and Indiana have had success enrolling thousands of kids via these groups using paid incentives. Any or all of these strategies could prove useful to Medicaid program administrators in the years to come as the pool of eligible individuals is set to swell tremendously.

On Monday, Connecticut announced that it would be the first state to move low income residents to the Medicaid program.  This shift will allow the state to save over 53 million dollars over the next year.  Because the government made changes in the Medicaid program to allow low-income singles without kids to enroll in Medicaid for the first time Connecticut was able to move these people from the State Administered General Assistance (SAGA) program.

Low-Income Single Adults Eligible for Medicaid in CT

Medicaid provides a wider range of health services than SAGA, and by enrolling low-income singles in Medicaid, Connecticut will save money and provide the approximately 45,000 qualifying individuals with more medical care.  Before the Affordable Care Act, adults without kids did not qualify unless the state allowed exceptions. On top of the savings, Connecticut will get some cash from the federal government for this endeavor. Kathleen Sebelius, Secretary of Health and Human Services Department, lauded Connecticut for early enrollment because it

The District of Columbia also followed Connecticut’s lead, and requested the government to expand its own Medicaid program, slashing over 56 million dollars from the city’s budget.  Both Connecticut and Washington, DC took advantage of the Affordable Care Act.  By 2014, every state will need to expand its Medicare coverage with federal funding, so successes in Connecticut and DC could indicate overall success for the Affordable Care Act.

Are states finally accepting the Affordable Health Care Act? Hopefully Connecticut and Washington, DC’s Medicaid expansion will truly prove successful in reducing expenses and providing citizens with quality health care.

WellCare was accused for falsely inflating expenditure information submitted to Florida Medicaid between 2002 and 2006. Money that was supposed to be used to provide medical services for Florida health care programs, WellCare kept for itself.

The U.S. Attorney’s office and WellCare Health Plans Inc. came to an agreement this year in order for WellCare to avoid fraud conviction. WellCare agreed to pay $80 million; $40 million in restitution to Florida agencies and $40 million in civil forfeiture. WellCare also accepts full responsibility for their actions, agreed to pay an independent monitor to review its operations, and agreed to fully cooperate with the government’s ongoing investigation.

WellCare has already paid $35.2 million, agrees to pay another $25 million by Sunday, and the remaining $19.8 million by the end of the year. As long as WellCare complies with all health care laws and regulations, the agreement can be cut down to two years from three.

The U.S. Department of Health and Human Services hopes that this agreement will serve as a warning to all committing or thinking of committing Medicaid fraud.

To read the full article, go to http://www.bizjournals.com/orlando/stories/2009/05/04/daily25.html

“Providing health care to more than ten million children through the Children’s Health Insurance Program will serve as a down payment on my commitment to ensure that every American has access to quality, affordable health care,” said President Barack Obama. He also stated that “As the worsening economy causes families to lose their jobs and health insurance, it is vital that we redouble our efforts to ensure that every child in America has access to affordable health care. That is why I am pleased that the Senate has joined the House in passing bipartisan legislation to provide health insurance to children whose families have been hurt most by this downturn.”

The Senate passing of legislation that will provide government-sponsored health care to approximately 4 million uninsured children is the start of Obama’s health care overhaul. The bill was approved yesterday 66 to 32 and will insure children in families that earn too much to qualify for Medicaid but not enough to afford private health insurance, increasing the amount of children who will be covered from 7 million to 4 million. The joint state-federal program will cost an additional $32.8 billion on top of the $25 billion over the next 4 ½ years. The expansion would be paid for by raising the cigarette tax from 39 cents a pack to $1.

“Low-income, uninsured kids all across America have been waiting for Congress to fulfill the promise of the Children’s Health Insurance Program for them,” said Senate Finance Committee Chairman Max Baucus. The House passed a nearly identical bill a few weeks ago with a vote of 289 to 139.

Similar legislation had been vetoed twice by former President George W. Bush. On the other hand, President Obama is eager to sign the legislation to begin the coverage that will hopefully lead to coverage for all Americans.