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My view: The Medicaid and CHIP programs work

By Lincoln Nehring

Published: Tuesday, Oct. 8 2013 12:00 a.m. MDT

For too many families, applying for Utah's Children's Health Insurance Program (CHIP) or Medicaid programs means navigating a complicated, unnecessary bureaucracy where the process trumps the person.

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Let's face it. For too many families, applying for Utah's Children's Health Insurance Program (CHIP) or Medicaid programs means navigating a complicated, unnecessary bureaucracy where the process trumps the person. Utah families' low enrollment and high uninsured rates are a direct result of this needlessly difficult eligibility system.

As the Deseret News reported last month ("Many children remain unnecessarily uninsured in Utah," Sept. 23), Utah lags well behind the national average and is second to last among states in terms of CHIP and Medicaid enrollment. Catching up to the national average of 87 percent participation would reduce the number of uninsured in Utah by more than 50,000 children — a third of the uninsured children in our state.

Why has Utah struggled so mightily to connect our kids with the coverage we've already decided they should have? While most of the country has simplified eligibility rules and proactively worked to help families sign up for coverage, Utah has too often done the opposite. We have antiquated and burdensome rules that discourage families from enrolling or cause a child to lose coverage because the family cannot keep up with the ongoing paperwork.

Utah families will get some relief thanks to some important changes to the rules. Starting Jan. 1, Utah will remove the family asset test for kids enrolling in Medicaid, bringing our rules in line with the national norm. However, to make sure all our kids have health coverage, Utah can, and should, do more.

There are many other common-sense policies Utah should adopt to help children enroll and stay enrolled in health coverage.

First, Utah should allow families to sign up for coverage for an entire year. Called 12 month continuous eligibility, it is a concept familiar to most of us with private insurance coverage. We submit our application and enroll in a plan once per year. Families with Medicaid coverage have to reapply and submit new paperwork constantly throughout the year to maintain coverage. Utah currently provides 12 months of coverage for kids in CHIP, but we should do it for those enrolled in Medicaid as well.

Second, we should eliminate waiting periods that require a child to be uninsured for months before enrolling in CHIP. No child should have to go without coverage, putting the child's health or financial security at risk simply so the child can qualify for health coverage. Allowing families to sign up their children as soon as they need it would go a long way in improving Utah's eligibility system.

Third, Utah should reduce the CHIP premiums, which are among the most expensive in the country. Next year, CHIP will be available only to families earning between $21,400 and $31,000 a year for a single parent and child. A premium of $75 every three months can be a real burden on the budget for families in this income range.

Fourth, we should promote Medicaid and CHIP and educate Utah families about the importance of health coverage. Health coverage does so much more than help pay for a doctor. Kids with health coverage miss less school, get better grades and are more likely to go to college. Families with health coverage are more financially secure and less likely to experience catastrophic events that will lead to bankruptcy.

Medicaid and CHIP work. Other states show they can reach more of the kids who need them. Let's demonstrate our commitment to putting Utah children on a pathway to success by getting every uninsured child enrolled in health coverage.

Lincoln Nehring is a senior health policy analyst at Voices for Utah Children. He serves as chairman of the Utah Department of Health Medical Care Advisory Committee and as a consumer representative for the National Association of Insurance Commissioners.

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