Jackson Free Press

Pennsylvania Sen. Bob Casey is pushing an amendment to keep children in the national Child Health Insurance Program from getting rolled into an insurance exchange.

More than 500 advocacy centers signed on to endorse Casey's amendment to the Senate health-care reform, all fearing that the bill, without the amendment, will leave many children uninsured.

"Our nation has made great strides over the last decade in securing health coverage for low-income children of working families. We must now seize this historic opportunity to build on the success of prior efforts and the bipartisan CHIP program, and ensure that children will be better off, not worse off, as a result of health reform," the group wrote to Casey in a Dec. 9 letter. "Your amendment will do just that."

The Patient Protection and Affordable Care Act, H.R. 3590 would impose new regulations upon the health-care industry and expand health-care coverage to about 30 million individuals who currently do not qualify for government coverage or can't afford private insurance.

Casey's amendment requires all states cover children from families earning up to 250 percent of the federal poverty level by 2014. (Up to $55,125 in annual income for a family of four). However, Mississippi currently only offers state health care to children and their families up to 150 percent of the federal poverty level ($16,245 a year for an individual and $27,465 a year for a family of three).

Children's Defense Fund's Southern Regional Office Director Oleta Fitzgerald argues that the current bill, without the amendment, would remove children from the CHIP program and put them into an insurance exchange, potentially adding expenses that many poor parents can't afford.

Fitzgerald said earlier this month that an insurance exchange, as envisioned by the Senate bill, is not as reliable a method to obtain health-care coverage as government coverage.

"Going into the exchange could require co-pays and premiums, the children would get lumped in with adults, and it's not clear what requirements the insurance companies would have for their benefit package," Fitzgerald said.

Fitzgerald also questioned the stability of exchanges, since other exchanges have failed in states like California and Texas, due to insurance companies laying claim to healthy customers and steering sickly customers into the exchange—thus raising the price of exchange participation for all its members.

Casey's November amendment protects CHIP-eligible children by extending their participation until the new exchange can be vetted, and it creates a monitoring agency to by making sure the transition is worthwhile.

"My amendment to the Senate health-care reform bill will strengthen coverage for children in CHIP through 2019 to ensure quality care for all vulnerable children," said Casey in a statement on his Web site. "The benefits of health care for children, particularly low-income children and children with special needs, are beyond dispute. Such care will not only help kids developmentally, do better in school and put them on a healthy path in life; it will also reduce long-term health care costs."

The Casey amendment continues CHIP funding through 2019 until the new insurance exchange can prove its permanence, but it also requires the completion of a report in 2016 that will compare coverage and benefits for low-income children under CHIP to the health care exchange created in the reform bill. It also increases federal matching funding for states that implement best practices for enrolling children, and ensure that states do not reduce eligibility levels already in place on Oct. 1, 2009.

Francis Rullan, spokesman for the Mississippi Department of Medicaid, said the aspect of the amendment expanding CHIP eligibility made him nervous.

"If we have to raise the eligibility requirements for CHIP coverage, it would affect us in the tens of millions of dollars," Rullan said.