Officials Hope Newly Announced Medicaid Rules Will Speed Approval of Healthy Families Waiver
Although California's "ambitious proposal" to extend Healthy Families coverage to more than 300,000 low-income parents and children has been stalled for seven months, state officials have "expressed hope" that this weekend's announcement (see story 6) by President Bush of changes to Medicaid policy could mean the expansion "will become a reality," the Los Angeles Times reports. During his weekly radio address, Bush said he would ask administration officials to adopt new rules that will make it easier for states to alter their Medicaid and CHIP programs. Earlier this year, California asked the federal government to approve a waiver that would allow the state to expand Healthy Families, the state's CHIP program, to cover parents. Under that waiver, a family of four would pay between $576 and $816 per year in total costs for comprehensive care. Costs for children's coverage range between $4 and $9 per month; if the waiver is approved, parents would pay $20 to $25 per month for their own coverage.
Although California officials believed the waiver's terms and conditions had been determined during June meetings with HHS, "nothing further happened" after those meetings. On July 27, California Health and Human Services Agency Secretary Grantland Johnson wrote HHS Secretary Tommy Thompson, saying, "The effect of holding up approval of California's waiver not only delays expanded coverage for families, but I believe, is inconsistent with the vision of state flexibility and innovation that you have articulated." Kevin Keane, HHS assistant secretary for public affairs, responded: "We want to work with California and we will address the issues as expeditiously as possible." He said the state's waiver application contains some "technical problems" but did not specify what those issues are. One of the reported "stumbling blocks" to the waiver's approval is how the state would calculate a family's income. California wants to permit parents to disregard a portion of child support money they receive when calculating their income to apply for the program. Further, the state wants to allow parents who pay child support to be able to deduct part of that amount from their income. The waiver application is the "first step in an anticipated expansion of" Healthy Families. As the second step, Gov. Gray Davis (D) recently approved a state budget that would allow parents with annual incomes of up to $44,000 per year, or 250% of the federal poverty level, to enroll in the program. Under the first waiver, parents would be covered at 200% FPL, while children in families with annual incomes up to 250% FPL are eligible for Healthy Families. The state must apply for a second federal waiver to receive approval to enroll parents at the higher income level (Rosenblatt, Los Angeles Times, 8/5).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.