CHIP funding battle wages on

By MIKE DENNISON

Within the next week, the Legislature must settle a partisan battle over funding Healthy Montana Kids, the expansion of children’s health-insurance approved by voters last November.

Most Republicans in the Legislature want to fund a program smaller than what voters overwhelmingly approved in Initiative 155. GOP senators have amended their version into budget bills before the Legislature.

Democrats, including Gov. Brian Schweitzer, are insisting the Legislature fully fund I-155, and say the GOP plan will forego some $50 million in federal funding for health insurance, leaving 14,000 kids uncovered.

Yet the GOP proposal still expands Medicaid and the Children’s Health Insurance Plan, two government-funded health insurance programs that cover kids in low- and moderate-income families.

How do the two proposals differ? What are the facts? Here’s a closer look:

Expansion of eligibility
Under I-155, Montana families can earn up to 250 percent of the federal poverty level and have their kids covered by CHIP. Current law sets the

ceiling at 175 percent.

The GOP plan increases CHIP eligibility to 200 percent of the federal poverty level.

Both plans increase the Medicaid eligibility from 100 percent to 133 percent of the federal poverty level, for kids ages 6 to 18.

For a family of four, 133 percent of the poverty level is an annual income of about $29,300. At 200 percent, it’s $44,100; at 250 percent, it’s $55,125.

Montana’s current CHIP ceiling of 175 percent is one of the three lowest levels in the country, among the states. Only North Dakota has a lower level, at 150 percent, and Alaska also is at 175 percent.

State health officials say nine states are moving their CHIP eligibility ceiling to 300 percent of the federal poverty level this year, and that New York is going to 400 percent, or $88,200 for a family of four.

Number covered

Expanding CHIP and Medicaid to I-155 levels would cover an estimated 29,000 Montana kids who are without health insurance.

The Republicans’ proposal would cover an additional 15,000 children. CHIP currently covers about 18,300 kids in Montana from low- and moderate-income families.

Cost

The Republicans’ proposal will cost the state an additional $10.3 million over the next two years and bring in another $35 million in matching federal funds, to pay for the expanded insurance.

Fully funding I-155 would cost the state $23.7 million the next two years and bring in nearly $80 million in federal matching funds.

Starting point

Both expansions would begin in October.

Senate Minority Leader Carol Williams, D-Williams, blasted Republicans last week for leaving $50 million in federal money “on the table” by not fully funding the I-155 expansion.

Her comment is essentially accurate. The federal government sets its matching funds for CHIP this year, based on how much money states commit to the program for two years.

By setting the income ceiling at 200 percent of the poverty level instead of 250 percent, Montana would forego approximately $45 million in available federal funds for the 21 months starting in October, or about $50 million over two years. It’s not known whether more federal matching money would be available if Montana chose to increase its share in 2011.

Sen. Dave Lewis, R-Helena, who has sponsored the amendments to enact the GOP plan, said Wednesday he’s not that concerned about leaving federal money unspent.

Of greater concern, he said, is whether the state can uphold its share of the program in the future, if the economy lags. For that reason, the expansion should be smaller than approved by voters, he said.

“I don’t want to buy into a program that we can’t sustain,” he said. “I’m just a balance-the-budget guy. I don’t want to have to cut the program (in the future).”

Anna Whiting Sorrell, director of the Department of Public Health and Human Services, said “the most important distinction” between the two proposals is that the GOP plan doesn’t cover 14,000 kids, who eventually would be covered if I-155 is fully funded.

“That’s what the voters voted for,” she said Wednesday. “We really have a mandate from the people. That’s what gets lost in this whole discussion: The faces of those 14,000 kids.”