Kids go uninsured in eligibility gap

from the Columbus Dispatch

Family incomes too high, too low for aid

By Catherine Candisky

All eight Ohio families that have applied for a new health-care buy-in program for uninsured children with special needs earn too little to qualify for coverage.

That's right. They're too poor.

It seems the families, with a combined 10 children, fall into a new no man's land in Ohio's Medicaid program.

They earn too much to qualify for the State Children's Health Insurance Program, which offers tax-funded coverage at no charge, and too little for the buy-in program for middle-class youngsters uninsured because of pre-existing or chronic conditions.

Gov. Ted Strickland's administration announced yesterday that it will ask legislators to approve a plan to ease eligibility for the buy-in program in an attempt to close the gap.

Funded entirely with state money, the buy-in program was launched April 1 for uninsured children in families earning more than 300 percent of the federal poverty level, making the cutoff $63,600 a year for a family of four.

Strickland spokesman Keith Dailey said the governor wants to lower eligibility to 250 percent of the poverty level, which is $53,000 a year for a family of four.

If approved, the expanded program is expected to cost $10 million over the rest of the state's two-year budget period, which ends June 30, 2009.

Dailey said money set aside but not spent for the State Children's Health Insurance Program would cover the cost. Ohio has about $11.5 million available because of delayed program expansions, he said.

There wasn't supposed to be a gap under the plan that was approved last year by the Republican-controlled General Assembly at Strickland's request. The hole was created in December, when the Bush administration denied Ohio's request to include middle-class families in its Children's Health Insurance Program.

Strickland, a Democrat, filed an administrative appeal of the decision, and a federal report released last week might boost that effort. The Government Accountability Office found that the Bush administration violated federal law when it restricted requests by Ohio and other states to expand coverage. Federal approval is required because costs are split between the states and the federal government.

The Bush administration rejected Ohio's request to expand eligibility by covering children in families earning up to 300 percent of the federal poverty level. The current cap is 200 percent.

Federal regulators suggested that Ohio seek a more modest expansion, suggesting 250 percent of the poverty level. Ohio complied and is awaiting a decision.

President Bush and Congress have been locked in a battle over the future of the program, and the president has twice vetoed legislative attempts to expand funding to the program.