NCPA - National Center for Policy Analysis

States Work to Reduce Growth in Children's Programs

December 19, 2003

States have applied a variety of techniques to slow spending on the State Children's Health Insurance Program (S-CHIP), a federal-state program that helps children of low-income, working parents.

These money-saving methods tend to reduce the number of children enrolled in state programs, and thus reduce costs:

  • Kentucky requires families applying for help to meet with an aid worker; government officials say this helps prevent fraud, but children's advocates say it's a barrier designed to keep eligible children out of the program.
  • Minnesota stopped automatically enrolling infants in MinnesotaCare this year.
  • Last year, Nebraska eliminated a provision in its Kids Connection program that had essentially exempted 20 percent of a family's earnings from the state's income eligibility threshold; as a result, many families' incomes were too high to qualify their children for enrollment in Kids Connection.
  • Some states have simply increased the premiums that families must pay to enroll in a children's health insurance program; Nevada doubled its premiums for families enrolled in the state's Check-Up program, before the change the highest premiums had been $35 every three months, now they are $70 every three months.

State officials determined that the increase in premiums would not have a significant impact on program participants. However, several recent studies have shown that even small increases in costs to low-income families on state-run health insurance plans can cause a portion of them to leave the program.

Source: Larry Wheeler, "Range of Tactics Applied to Limit Programs' Growth," USA Today, December 19, 2003.

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