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June 2008

Recent State Updates

Arkansas: Arkansas Advocates for Children and Families launched a statewide effort to increase enrollment in the state’s children’s health insurance program, ARKids First, by approximately 22,000 children over the next three years. According to Arkansas Advocates for Children and Families, 11 percent, or 70,000 of Arkansas children, are uninsured. Of those, 40,000 are eligible for ARKids First but are not enrolled in the program.

This initiative is part of the Finish Line Project, which is funded through a $675,000 grant from the David and Lucile Packard Foundation, created by the cofounder of Hewlett-Packard. Arkansas will also receive an additional $264,000 in federal matching grant money. Arkansas is one of eight states participating in the Finish Line project, which has the goal of ensuring that all of America’s children have health insurance. Other states participating in the project include California, Colorado, Iowa, Ohio, Rhode Island, Texas, and Washington.

Arkansas Advocates for Children and Families is also working with the state Department of Human services and federal officials to extend eligibility for the program from 200 percent of the federal poverty level (FPL) ($42,400 for a family of four) to 300 percent FPL ($63,600 for a family of four). Expanding eligibility would mean that approximately 20,000 Arkansans could enroll in the program.

Minnesota: Governor Tim Pawlenty signed omnibus tax bill H.F. 3149 into law May 29. The law provides small employers—those employing between two and 50 workers— a new tax credit for establishing Section 125 plans for employees to purchase health insurance with pre-tax dollars. The credit allows for employers who do not currently provide health insurance to their employees to receive up to a $350 credit in total to defray the cost of setting up the section 125 plan. Businesses must have tax liability in order to quality for the tax credit. A Section 125 plan allows employees to purchase health insurance with pre-tax dollars, which provides individuals with significant savings.  

North Dakota: On June 5, the federal Centers for Medicare and Medicaid Services (CMS) approved North Dakota’s request to expand eligibility for its Health Steps State Children’s Health Insurance Program.

Currently, the program is limited to children in families that have a net income of 140 percent FPL, approximately $29,600 for a family of four. Beginning October 1, families earning up to 150 percent FPL ($31,800 for a family of four) will be eligible for SCHIP coverage.

An additional 800 uninsured children are expected to gain coverage during the first year of the expansion. However, because North Dakota families can disregard child care expenses, payroll taxes, child support and other expenses when calculating their income in determining eligibility, children in some families earning close to 200 percent FPL may qualify for coverage.

Utah: Utah's Medicaid program is working to decrease overutilization of all health care services, in particular nonessential visits to the emergency room (ER). With the aid of a $503,000 federal grant, this new program will reroute patients who visit emergency rooms to primary care physicians who can provide continual, less expensive care. After one visit to the ER for care deemed "non-emergent," Medicaid patients will receive a phone call from the state encouraging them to visit a family doctor. They also will be educated as to when it is appropriate to go to an ER. In the past, only those who made three or more trips to an ER in a single year were contacted.

This program is part of a larger effort by the Centers for Medicare and Medicaid Services to contain costs and improve quality of care. Approximately $50 million in grants, designated by the Deficit Reduction Act of 2005, will be given out to 20 states in order to help fund state initiatives that decrease nonessential emergency room visits.

In Utah, nearly 33,000 ER visits were considered non-emergent in 2006— the most recent year that data are available. Reasons for nonessential ER visits include lack of time and transportation to go anywhere else, as well as a lack of education and a connection to a primary care doctor.

Earlier, on March 19, 2008, Governor Jon Huntsman signed bill House Bill 133, which requires the Department of Health, the Insurance Department, and the Governor's Office of Economic Development to work with the legislature to develop a strategic plan for health system reform. Specifically, a task force comprising legislators from both the House and the Senate will study the issue. The task force replaces broader plans originally laid out to expand health coverage to Utahns.

The enactment of HB133 also expands the State's premium subsidy program Utah's Premium Partnership for Health Insurance (UPP), from employer-sponsored plans to also include individual plans. In addition, approval for UPP will now be considered a qualifying event for enrollees to apply for their employer-sponsored health insurance. In the past, UPP enrollees would have to wait for their annual open enrollment period to apply for work-sponsored coverage. However, with the passing of House Bill 133, UPP will now enable those who are approved for the program the opportunity to enroll in their work's health plan year round.