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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