SCHIP growth under study
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Costs of covering legal immigrants’ children weighed
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State health officials are analyzing the cost of expanding Louisiana’s health insurance program for children to also cover the children of legal immigrants.
Louisiana, like other states, could provide the coverage to children in homes where the parents are on track to become U.S. citizens under federal legislation that has passed the U.S. House of Representatives.
The provision is part of federal legislation that would renew and expand the State Children’s Health Insurance Program, known as SCHIP, and implement a hefty cigarette tax to help fund it.
It has become an immigration issue among some Republicans in Congress who oppose the expansion.
Some version of the legislation is expected to win final approval.
Republican Gov. Bobby Jindal refused to be interviewed on what his health secretary terms a “public policy” issue.
Jindal’s Chief of Staff Timmy Teepell said the immigration issue is one that the governor doesn’t yet have to face because the legislation hasn’t passed.
The administration has told the members of the state’s congressional delegation that a top Louisiana priority is renewal of SCHIP, which provides health insurance to children in low- to moderate-income households. But it has not weighed in on legislation specifics.
The SCHIP program has allowed Louisiana to go from having 20 percent or more uninsured children to about 5 percent uninsured children — a statistic that gives state officials hope of improved health and reduced medical costs.
State Department of Health and Hospitals Secretary Alan Levine said his agency is gathering information on how many immigrant children could be eligible for the insurance coverage and the financial impact should the state go that route.
“Louisiana has a clear record of opting to cover as many children as we can. I don’t think that is going to change,” Levine said. “We need to do the financial analysis of what it’s going to cost and can we afford it.”
Going into the next budget year, the health care agency is facing the potential of deep cuts — although a federal, economic stimulus package could relieve the financial stress.
The health status of the state’s immigrant population counts against Louisiana when national rankings are done, Levine said.
Louisiana already covers pre-natal care of legal immigrants — a policy that started in mid-2007 under former Gov. Kathleen Blanco, a Democrat.
Levine said there is no plan to reverse that decision.
While a woman is not eligible for medical care under federal policy, her fetus is eligible for services related to the pregnancy. The child born to the legal immigrant becomes an American citizen and continues to get Medicaid or SCHIP coverage.
“The mother is eligible until the baby is born,” said DHH health executive Ruth Kennedy. The mother also gets medical care during pregnancy that relates only to the health of the fetus, she said.
Prior to that decision, Kennedy said, the costs of labor and delivery were paid, but prenatal care expenses were not paid. The lack of prenatal care could lead to problems with delivery and in the health of the baby, resulting in sometimes-exorbitant expenses, she said.
Some 3,718 pregnant women who were not U.S. citizens received prenatal care under the state program between July 1, 2007, and June 30, 2008 — the last full state fiscal year. The services cost $15.6 million — $13.6 million paid for with federal funds and the remaining $2 million funded with state revenues.
Currently, there are 1,260 women enrolled in the program, according to state health agency statistics. More than half of them live in three parishes — Jefferson, Orleans and East Baton Rouge.
The entire Louisiana SCHIP program covered 164,412 children from low- to moderate-income households at a total cost of $190 million in state and federal funds last budget year, according to health agency statistics.
Kennedy said the state looks at an individual’s immigration papers and green card and gets numbers to verify the individual’s legal status through a U.S. Department of Homeland Security database.
Today, Kennedy said, the state is turning down applications of parents who are seeking health insurance for their children because of a federal rule that denies coverage until they have been in the U.S. for five years.
“Is it in the thousands? No. Hundreds? Probably,” Kennedy said.
“From a public policy standpoint … those parents are following the rules,” Kennedy said. “They are hard-working and pay taxes, but they are not able to get public coverage until they have been here for five years.
“It’s a wise investment in preventive and primary care,” she continued. “As we work to continue to reduce the number of uninsured children in the state, it is one of the tools that may become available to us.”
Kennedy said 20 states and Washington, D.C., already cover these children by using state dollars.
Legislative leaders approach children’s insurance expansion with different views.
House Health and Welfare Committee Chairwoman Kay Katz, R-Monroe, said she is hesitant about expanding coverage. She said she wants to know more about how the children are getting medical care today.
“I don’t know of any health system that’s going to turn away a sick child. I don’t know of that at any level,” Katz said. “Are we treating those children anyway? Are they being treated as a portion of our uninsured?
“The reason SCHIP was put into effect was to give opportunity to help children from some lower economic backgrounds. There’s a point where we must say, ‘Let’s take care of our own first,’” said Katz, mirroring the concerns expressed by some Republicans in Congress.
It is important that the families seeking insurance for their children are legal immigrants going through the regular federal process toward becoming citizens, said state Senate Health and Welfare Committee Chairwoman Willie Mount, D-Lake Charles.
“Let’s pursue it, study it and review it with whatever information we get back from DHH,” Mount said.
State Senate Finance Committee Chairman Mike Michot, R-Lafayette, said financial considerations are important because coverage could save the state money in the long term.
Michot said many people are “falling through the cracks now and showing up on the steps of emergency rooms.” If federal funds can be obtained to cover the costs, then the expansion could be a good thing, he said.
Louisiana, like other states, could provide the coverage to children in homes where the parents are on track to become U.S. citizens under federal legislation that has passed the U.S. House of Representatives.
The provision is part of federal legislation that would renew and expand the State Children’s Health Insurance Program, known as SCHIP, and implement a hefty cigarette tax to help fund it.
It has become an immigration issue among some Republicans in Congress who oppose the expansion.
Some version of the legislation is expected to win final approval.
Republican Gov. Bobby Jindal refused to be interviewed on what his health secretary terms a “public policy” issue.
Jindal’s Chief of Staff Timmy Teepell said the immigration issue is one that the governor doesn’t yet have to face because the legislation hasn’t passed.
The administration has told the members of the state’s congressional delegation that a top Louisiana priority is renewal of SCHIP, which provides health insurance to children in low- to moderate-income households. But it has not weighed in on legislation specifics.
The SCHIP program has allowed Louisiana to go from having 20 percent or more uninsured children to about 5 percent uninsured children — a statistic that gives state officials hope of improved health and reduced medical costs.
State Department of Health and Hospitals Secretary Alan Levine said his agency is gathering information on how many immigrant children could be eligible for the insurance coverage and the financial impact should the state go that route.
“Louisiana has a clear record of opting to cover as many children as we can. I don’t think that is going to change,” Levine said. “We need to do the financial analysis of what it’s going to cost and can we afford it.”
Going into the next budget year, the health care agency is facing the potential of deep cuts — although a federal, economic stimulus package could relieve the financial stress.
The health status of the state’s immigrant population counts against Louisiana when national rankings are done, Levine said.
Louisiana already covers pre-natal care of legal immigrants — a policy that started in mid-2007 under former Gov. Kathleen Blanco, a Democrat.
Levine said there is no plan to reverse that decision.
While a woman is not eligible for medical care under federal policy, her fetus is eligible for services related to the pregnancy. The child born to the legal immigrant becomes an American citizen and continues to get Medicaid or SCHIP coverage.
“The mother is eligible until the baby is born,” said DHH health executive Ruth Kennedy. The mother also gets medical care during pregnancy that relates only to the health of the fetus, she said.
Prior to that decision, Kennedy said, the costs of labor and delivery were paid, but prenatal care expenses were not paid. The lack of prenatal care could lead to problems with delivery and in the health of the baby, resulting in sometimes-exorbitant expenses, she said.
Some 3,718 pregnant women who were not U.S. citizens received prenatal care under the state program between July 1, 2007, and June 30, 2008 — the last full state fiscal year. The services cost $15.6 million — $13.6 million paid for with federal funds and the remaining $2 million funded with state revenues.
Currently, there are 1,260 women enrolled in the program, according to state health agency statistics. More than half of them live in three parishes — Jefferson, Orleans and East Baton Rouge.
The entire Louisiana SCHIP program covered 164,412 children from low- to moderate-income households at a total cost of $190 million in state and federal funds last budget year, according to health agency statistics.
Kennedy said the state looks at an individual’s immigration papers and green card and gets numbers to verify the individual’s legal status through a U.S. Department of Homeland Security database.
Today, Kennedy said, the state is turning down applications of parents who are seeking health insurance for their children because of a federal rule that denies coverage until they have been in the U.S. for five years.
“Is it in the thousands? No. Hundreds? Probably,” Kennedy said.
“From a public policy standpoint … those parents are following the rules,” Kennedy said. “They are hard-working and pay taxes, but they are not able to get public coverage until they have been here for five years.
“It’s a wise investment in preventive and primary care,” she continued. “As we work to continue to reduce the number of uninsured children in the state, it is one of the tools that may become available to us.”
Kennedy said 20 states and Washington, D.C., already cover these children by using state dollars.
Legislative leaders approach children’s insurance expansion with different views.
House Health and Welfare Committee Chairwoman Kay Katz, R-Monroe, said she is hesitant about expanding coverage. She said she wants to know more about how the children are getting medical care today.
“I don’t know of any health system that’s going to turn away a sick child. I don’t know of that at any level,” Katz said. “Are we treating those children anyway? Are they being treated as a portion of our uninsured?
“The reason SCHIP was put into effect was to give opportunity to help children from some lower economic backgrounds. There’s a point where we must say, ‘Let’s take care of our own first,’” said Katz, mirroring the concerns expressed by some Republicans in Congress.
It is important that the families seeking insurance for their children are legal immigrants going through the regular federal process toward becoming citizens, said state Senate Health and Welfare Committee Chairwoman Willie Mount, D-Lake Charles.
“Let’s pursue it, study it and review it with whatever information we get back from DHH,” Mount said.
State Senate Finance Committee Chairman Mike Michot, R-Lafayette, said financial considerations are important because coverage could save the state money in the long term.
Michot said many people are “falling through the cracks now and showing up on the steps of emergency rooms.” If federal funds can be obtained to cover the costs, then the expansion could be a good thing, he said.
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