Families USA Health Action 2008

Covering Kids in Tenuous Times

How Georgia Coped with Federal Funding Shortfalls in 2007

Tim Sweeney, Georgia Budget and Policy Institute

“Tenuous Times” in Many Ways

• SCHIP federal funding shortfall

• Limited state resources

• Political climate in Georgia hostile to public healthcare programs

PeachCare Background

• Separate program• Covers kids up to 235% FPL• Monthly premiums, no co-pays

– $0 for kids under 6

– $10 to $35 per child, family max $20 to $70

Georgia’s Federal Shortfall

• PeachCare is the 4th largest SCHIP program (NY, CA, TX)– Beginning FY 07 enrollment >250,000

• FFY 07 allotment: $165.9 M• FFY 07 federal funds spent: $340 M

Used with the permission of the GA Department of Community Health

As Shortfall Loomed, PeachCare Dominated Session

• State pressured Fed. Govt. for funds

• Advocates pressured Governor to use state funds

• Legislature took break hoping for federal solution, introduced cuts

GA Speaker’s Proposal

• Reduce eligibility to 200% FPL– Allow agency to adjust between 185%-225%

• Benchmark coverage against state employee plan

• Carve out dental and vision benefits and charge additional premiums

Senate Substitute Plan

• Eligibility changes:– Under 125% FPL moved to Medicaid– Lower PeachCare eligibility to 200% FPL– New program for 200%-250% FPL (member premiums

of 5% of family income, no federal or state funds)

• Increase monthly premiums to 1.5% family income, add $25 ER co-pay (non-emer.)

• Retain basic dental, premium for comp. coverage

So – What happened?

• PeachCare enrollment frozen in March– Re-opened in July with cap of 295,000

• State funds used to sustain program

• No Legislative Action… for now.

• Citizenship and income verification

• Significant enrollment declines since April 2007

PeachCare Enrollment Declines

Dec-07, 254,820

Jun-07, 276,551

Apr-07, 290,757

Oct-06, 277,432

200,000

220,000

240,000

260,000

280,000

300,000

Jan-

06

Apr-06

Jul-0

6

Oct

-06

Jan-

07

Apr-07

Jul-0

7

Oct

-07

Enrollment Freeze March 11, 2007

Enrollment Reopened July 2007

Our Good News

• August directive does not affect Georgia

• State estimates $325 M in fed funds available in FY 2008– Would allow additional 40,000 kids to enroll

(to reach current 295,000 child cap)

• PeachCare to resume outreach activities

Georgia Budget and Policy Institute

Tim Sweeney, Senior Health Care Analyst

100 Edgewood Avenue, Suite 950Atlanta, Georgia 30303

404- 420 -1324 www.gbpi.org