WASHINGTON – A federal decision to release Medicaid funding to Maryland should help the state expand its children’s health insurance program to include families that earn up to 300 percent of the poverty level, state officials said.
While state officials geared up to meet their new goals, however, some independent child health specialists said Maryland has yet to cover all children who meet the current eligibility guideline of 200 percent of the federal poverty level.
“The state has not met their primary goal,” said Miriam Alexander, professor at the John Hopkins School of Public Health. “Just because they say that a family has access to their child insurance program doesn’t mean they actually do.”
But state officials said last week that they have “far exceeded our target” for signing up children who meet the current guidelines and they are ready to begin advertising the expanded criteria, which are scheduled to take effect July 1.
The new eligibility criteria in Maryland were approved earlier this year by the General Assembly. The guidelines will make it possible for a family of two with annual income of $33,750 or less to qualify for the Maryland Children’s Health Program. Also qualifying would be a three-member family with an annual income up to $42,450 or a family of four with an income up to $51,150.
The expansion will be funded in part with $21 million that federal officials had previously said could only be used for a federal version of the children’s health insurance program, not the state version. But the federal Health Care Financing Administration relented last month.
State officials said the new money would be used to draw down a $24 million deficit in the state Medicaid program as well as to begin expansion of the children’s insurance program.
“Apart from reducing our Medicaid deficit to $9 million, out of the total investment of $1.2 billion (for Medicaid), we are now more adequately funded to increase the state’s eligibility criteria for child insurance to 300 percent of the poverty level,” said John Folkemer, executive director of planning and development for the Maryland Department of Health and Mental Hygiene.
But Alexander and others said the state has not yet covered all the families it could under current guidelines.
“First of all, getting signed for the state program is a huge process which some families find hard to do. And even if they do that, it does not mean that everything is taken care of from then on,” she said. “The state does not have enough centers in every nook-and-corner of the state to cater to the needs of these children.
“There may be a legislative mandate, but implementing the program is a different thing all together. The hoops are certainly not being met by the state,” Alexander said.
Bobby Seabolt, executive director at the American Academy of Pediatrics, agreed that state officials have not reached all currently eligible children, but she said they have been aggressive in their task.
“The state has tried to broaden their outreach, but are still missing out on certain children,” Seabolt said.
While state officials could not specify how many currently eligible children are not insured, they insisted that the state has been successful.
“We have been very aggressive in our approach and have far exceeded our target,” said Nancy Dieter, chief at the Maryland Children’s Healthcare division.
“Our goal when we started our program in July 1998 was to provide insurance for 60,000 children in two years. We have, in fact, insured 74,000 children who fall in the 200 percent eligibility criteria as of July 2000,” she said. “We have definitely been active and we will continue to do so.”