The Advocate (Louisiana), July 23, 2008: New LaCHIP plan insures more children
They work at car dealerships, engineering firms, oilfield supply businesses, government offices and retail stores such as Wal-Mart.
They are among the parents who have enrolled their children in a new state-subsidized health insurance program.
In its first month of existence, the new “Affordable Plan” in the Louisiana Children۪s Health Insurance Program, called LaCHIP, has allowed 622 children in moderate income families to get health insurance coverage.
The parents pay a $50 monthly premium no matter the number of children per household. There are deductibles and co-payments too.
“It۪s a pretty good deal,” said Crystal Bob, who recently enrolled her two young children. They have been diagnosed with attention deficit hyperactivity disorders.
“It helps a lot with the doctor visits,” she said.
A co-pay for medicine the children require still exists and costs can get expensive, but it is better than her prior situation, Bob said.
The children had been insured, but when their father died, the family lost coverage, Bob said. “I had not been able to afford health insurance. I was paying out-of-pocket,” said the 31-year-old New Iberia resident.
Bob said she had too much income previously for her children ages 4 and 6 to qualify for other government health programs.
Enter the Affordable Plan.
At no cost to parents, traditional LaCHIP covers children in families with incomes up to double the federal poverty level, which is a sliding scale dependent on the number of family members. That۪s a $42,400 value for a family of four.
The new plan covers children in families with incomes from double to 2‰ times the federal poverty level and parents must help cover costs. That۪s $53,000 for a family of four.
In Bob۪s family-of-three situation, it was the difference between incomes of $35,000 to $44,000 annually.
Families cannot drop private insurance coverage for their children and move to the new program under the state guidelines. The idea is to get more children on health insurance.
Today, 771,526 children have health insurance coverage through state Department of Health and Hospitals government-sponsored programs, DHH Secretary Alan Levine said.
Of that, 648,850 children get insurance through traditional Medicaid, the state insurance program for the poor. The remainder are enrolled in LaCHIP a program launched by the federal government to help low-income working families get health care for their children.
The new subsidized program requiring parental contribution to costs is an off-shoot of LaCHIP.
Information about LaCHIP and its Affordable Plan may be obtained by going to www.lachip.org or by calling (877) 252-2447.
DHH۪s budget projects the combined programs to add 28,500 more children in the fiscal year that began July 1, Levine said. Of those, 6,500 are projected to be LaCHIP and Affordable Plan members, he said.
“One thing I have been impressed with has been the assertiveness of our programs in getting our children enrolled,” Levine said. “I۪m proud of what our folks and community partners have done.”
But, Levine said, just because a child is enrolled in the programs doesn۪t guarantee access to care today because of a lack of a sufficient number of pediatric, general practice and specialty physicians that agreed to the reimbursement rates provided by Medicaid.
Levine said his agency is in the process of designing a program to fix that problem with the development of private provider networks of care similar to insurance plan offerings. Families would be able to choose from at least three plans.
The 622 children enrolled in the new Affordable Plan are involved in an experiment of sorts that for the first time does not require children to see physicians who are enrolled Medicaid providers.
The children, who are from 412 families, are covered through the state۪s Group Benefits insurance program. Group Benefits is Louisiana۪s insurance program for state employees, retirees and others.
Sandra Adams, director of the Louisiana Maternal and Child Health Coalition, said she is “pleasantly surprised that the numbers are that high for the first month of enrolment” in the new Affordable Plan.
But Adams said the program brings with it disparate treatment.
“It gives children access to private providers who have never been willing to accept Medicaid,” Adams said. “You are adding a category of some higher income families who, although they are participating in costs, get access to providers who have never been available.”
Adams said Levine continues to say he is concerned about access. But, she said, “I don۪t think he۪s doing anything to help solve the problem when he creates a new program” that changes the rules on how much physicians are paid.
In addition, Adams said children do not have dental benefits at this point through the Affordable Plan.