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January 2007

States Looking to Extend Coverage to All Children

Momentum is building to ensure all children have access to health coverage. Connecticut’s Husky B program, the state’s SCHIP program, was the first state in the nation to allow uninsured children in families above 300 percent of the federal poverty level (FPL) to buy into the program. Then, in November 2005, Illinois Governor Rod Blagojevich (D) signed the Covering All Kids Health Insurance Act, making insurance coverage available to all uninsured children in that state. Several states have followed Illinois’ lead.

The Illinois All Kids program was implemented in July 2006 and is open to any child uninsured for 12 months or more, with no citizenship requirements. Families pay monthly premiums and co-payments on a sliding scale basis. The expansion is funded through enrollee cost-sharing as well as savings generated from new care management initiatives. Since July 2006, over 28,000 children have enrolled in the new expansion program.

Pennsylvania’s General Assembly enacted the Cover All Kids program in October 2006. This new program will be implemented as a SCHIP expansion and will allow families to purchase health insurance on a sliding scale basis relative to their income. Families above 300 percent FPL will purchase coverage at full cost. The state aims to begin enrollment in March 2007 and cover 15,000 additional children in the first year of the program.

Tennessee also passed legislation to cover all children. The state is developing a new stand-alone SCHIP program for children in families with incomes up to 250 percent FPL (coverage for children had previously been a part of the TennCare program). Children in higher income families will be able to buy into the program.

In recent months, other states have announced similar proposals:

  • California Governor Arnold Schwarzenegger (R) announced plans to extend coverage to all California residents. Eighteen counties in California currently fund and operate programs to cover all children. More counties are expected to implement similar programs.
  • New Mexico Governor Bill Richardson (D) proposed the goal of insuring all children under age 5. New Mexico now offers a Premium Assistance program for uninsured children up to age 11 (and their siblings up to age 18) who are ineligible for Medicaid or SCHIP. 
  • New York Governor Eliot Spitzer (D) announced plans to cover all children by making premiums more affordable and simplifying enrollment. All children in New York are eligible for Medicaid or Child Health Plus (SCHIP) regardless of their income or citizenship. Subsidies are provided for families with incomes up to 250 percent FPL. 
  • Oregon Governor Ted Kulongoski (D) proposed a plan to cover uninsured children through an expansion of the Oregon Health Plan and a private purchasing arrangement for higher-income children. 
  • Washington Governor Christine Gregoire (D) announced a goal of providing coverage for all children by 2010.
  • Wisconsin Governor Jim Doyle (D) proposed extending the state’s Medicaid program, BadgerCare, to all uninsured children by 2007.