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May 2009

Recent State Updates


On April 24, the Iowa state Legislature approved a $7.5 million Children’s Health Insurance Program (CHIP) expansion to include children and pregnant women in families with incomes up to 300 percent FPL.  Supporters say this expansion will cover 53,000 uninsured children—virtually guaranteeing that all children in the state will have coverage.  The Legislature debated the bill throughout the legislative session, and ultimately, it passed with full support in the House and broad support in the Senate.  Senator Hatch, a Democrat from Des Moines, said that lawmakers look at this bill as a way to set the state on a path to expand coverage for adults.  This bill fits within the context of a broad health reform bill (House File 2539) that Iowa Governor Chet Culver signed into law in May 2008.[1]


Prior to her confirmation as Secretary of Health and Human Services, then Kansas Governor Kathleen Sebelius signed a bill (HB 2052) at the end of April that amends the Consolidated Omnibus Budget Reconciliation Act (COBRA) law in Kansas to cover up to 65 percent of premium costs through 2010 for former workers using COBRA benefits—a required provision of the American Recovery and Reinvestment Act (ARRA) of 2009.  Amending the state bill will help keep Kansas families insured and puts Kansas in compliance with the stimulus package requirements.[2]  In other Kansas news, the Senate and House approved a budget bill that funds the HealthWave (state CHIP) expansion for children in families with income up to 250 percent of the federal poverty level (FPL).[3]

New Jersey

Nearly one year ago, New Jersey Governor John S. Corzine signed a health reform bill (S. 1557) that introduced a child mandate for health insurance coverage, stating that all children 18 years and younger must have health insurance coverage through an employer-sponsored or individual health benefits plan, Medicaid, the NJ FamilyCare program, or the NJ FamilyCare Advantage buy-in program.  The bill also stipulated an ongoing enrollment initiative for Medicaid or NJ FamilyCare that requires individual taxpayers to indicate on their tax returns the health insurance coverage status of the taxpayer and dependents, if applicable, on the filing date.

In keeping with that bill, Governor Corzine and Human Services Commissioner Jennifer Velez announced on April 14 the new FamilyCare express lane application option that will serve to identify uninsured children who may be eligible for NJ FamilyCare.  This means that taxpayers will receive a simplified version of the state insurance application—known as the express lane application—if they indicate on their state tax forms that they have uninsured children in their homes.  Based on tax year 2008 documents, the state has determined that almost 250,000 residents have at least one uninsured child in their households.  Through collaboration between the Department of Human Services (DHS) and the Department of Treasury, DHS will begin mailing express lane applications this month.

While Iowa and Maryland also ask for uninsured child information from tax filers, New Jersey is the first and only state to use this information for targeted outreach and enrollment purposes.  NJ FamilyCare, the state’s CHIP, provides coverage for children in families with incomes up to 350 percent FPL and to parents with incomes up to 200 percent FPL.[4]


On May 6, Oklahoma Governor Brad Henry signed legislation aimed at providing residents with increased access to affordable private health coverage.  One of the key measures of the bill (HB 2026) requires that the Oklahoma Health Care Authority (OHCA) and the Insurance Department create the Health Care for the Uninsured Board (HUB)—also called the Oklahoma Exchange.  HUB will be tasked with certifying health insurance programs as recommended by HUB; educating consumers about how to choose a certified health plan and how to efficiently utilize care; and helping qualified individuals become enrolled in an Insure Oklahoma plan.  Insure Oklahoma is a public-private partnership that provides premium assistance to small business employers and employees, as well as to individuals without access to employer-sponsored insurance.  HB 2026 requires plans offered through Insure Oklahoma to make additional low-cost options available, such as high deductible plans that are compatible with a health savings account.

Other measures of the bill include providing incentives to businesses that offer Section 125 plans so employees can use pre-tax dollars to purchase health care coverage; reforming the individual market to enable insurance providers to offer basic preventative plans with catastrophic coverage; and establishing a program to initiate health insurance enrollment of uninsured patients at the point of health care service delivery.[5]


Oregon Governor Ted Kulongoski signed a bill (HB 2433) on April 28 to extend federal COBRA subsidies to former employees of small businesses, so that this group can also take advantage of the increased timeframe allowed—under ARRA, from six months to nine months—for former workers using COBRA benefits.  In addition, the bill requires that insurers notify all employer groups and individuals whose jobs end or ended between September 1, 2008 and December 31, 2009, of their eligibility for coverage.[6]



[1] Iowa Legislature Approves Health Expansion, AP/USA Today, April 24, 2009.
[2] Sebelius Signs Bill Expanding Health Coverage for the Unemployed, KWCH Eyewitness New 12,    April 14, 2009.
[3] Senate and House Approve Budget Bill, KHI News Service, March 31, 2009.
[4] Governor Corzine Announces New FamilyCare Express Lane Application Option, Office of New Jersey Governor Bill Richardson, press release, April 14, 2009.
[5] Gov. Brad Henry Signs Bill Strengthening Insure Oklahoma, Office of Governor Brad Henry, press release, May 6, 2009; Legislation Seeking to Reduce Oklahoma’s Uninsured Passes House, Office of House Speaker Chris Benge, press release, March 3, 2009.
[6] Oregon Would Help with Insurance Costs, USA Today, April 22, 2009.