California Says It Won’t Comply With Kids’ Insurance Directive
California will not comply with the federal State Children's Health Insurance Program directive scheduled to go into effect on Aug. 18 because state health officials say that "key requirements articulated in the directive are inconsistent with current California law," CQ HealthBeat reports (Johnson, CQ HealthBeat, 8/13).
According to guidelines issued by CMS in August 2007, before expanding SCHIP eligibility to children in families with incomes greater than 250% of the federal poverty level, states first must demonstrate they have enrolled at least 95% of eligible children with family incomes below 200% of the poverty level (California Healthline, 7/18).
Healthy Families, California's version of SCHIP, is the country's largest SCHIP program, receiving 16% of all federal SCHIP funds.
In a letter sent Tuesday to Herb Kuhn, deputy administrator of CMS and acting administrator of the Medicaid program, Managed Risk Medical Insurance Board Executive Director Lesley Cummings wrote, "MRMIB ... is constitutionally obligated to follow state law and cannot unilaterally change HFP operating rules that are embodied in state law."
At least four other states have legally challenged the directive, but the Bush administration maintains that the directive was not a regulation.
However, a Government Accountability Office report concluded that the directive was an illegally issued rule.
Cummings wrote, "At present, California will continue to operate the HFP, including eligibility, benefits and cost-sharing, in conformance with CMS-approved Title XXI state plan and will continue to claim federal funds accordingly."
In a statement, CMS spokesperson Jeff Nelligan said, "We are determining whether the relevant states are in compliance with the existing requirements, as also clarified in the Aug. 17, 2007, letter."
Nelligan added, "At this time, we are not taking compliance action" (CQ HealthBeat, 8/13).