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Kevin Avard Confronted, Admits He Just Doesn’t Like Medicaid Expansion

  When Pressed By A Voter, Avard Ducks and Condescends Before Finally Admitting He Just Opposes Expansion Because Of His Tea Party Ideology

Kevin Avard (via Girard FLIKR CC)

Kevin Avard (via Girard FLIKR CC)

Concord, N.H. – At a “Legislative Forum” in Nashua, a constituent pressed Kevin Avard repeatedly on why he supports repealing health care for the more than 38,000 Granite Staters already covered thanks to Medicaid expansion.

The constituent cited data from the New Hampshire Hospital Association showing that Medicaid expansion is working and uncompensated care is declining. Yet in the face of this data, Avard simply ducked and condescended before finally admitting that he just opposes expansion because of his Tea Party ideology.

Showing blatant disregard for the tens of thousands of Granite Staters who have already gotten covered by the program, Avard admitted, “I don’t like [Medicaid expansion]… I think it’s wrong, period. And in my view it’s socialism.”

Kevin Avard needs to listen to his own constituents and to the data that shows New Hampshire’s Medicaid expansion plan is working,” said New Hampshire Democratic Party Chair Ray Buckley. “Continuing New Hampshire’s successful Medicaid expansion plan is the right thing to do for our people, businesses, and economy, and voters will hold Avard accountable in November 2016 for putting his Tea Party ideology before the interests of New Hampshire.”

Click here for the full video.

NH Insurance Department: Residents Will Have Health Plan Choices in 2016

5 Health Insurance Companies, 4 Dental Carriers File to Offer Plans on Marketplace

CONCORD, NH – The New Hampshire Insurance Department announces that state residents will have a variety of health insurance options to choose from in 2016.

At the close of the April 15 deadline for filing 2016 plans, five health insurance companies had submitted applications to offer plans on New Hampshire’s federally facilitated Health Insurance Marketplace in 2016. Four companies had applied to offer stand-alone dental plans.

“For 2015, New Hampshire residents had a range of health insurance companies, plans, and provider networks to choose among,” said New Hampshire Insurance Commissioner Roger Sevigny. “I’m pleased that in 2016, they’ll likely have just as many options, if not more. Choice is good for consumers and good for competition.”

Health insurance companies that submitted applications to offer plans through the 2016 Marketplace include: Anthem Blue Cross and Blue Shield of New Hampshire, Harvard Pilgrim Health Care of New England, Community Health Options, Minuteman Health, and Ambetter from NH Healthy Families, offered by Celtic Insurance.

While some health insurance plans will include dental coverage, New Hampshire residents also will be able to choose among a variety of distinct dental plans. Four companies will offer stand-alone dental plans on the Marketplace: Anthem, Delta Dental, Dentegra Insurance Company, and Guardian Life Insurance Company.

New Hampshire is a partnership state, which means that the state is responsible for reviewing plans proposed for sale on the federally facilitated New Hampshire Health Insurance Marketplace and deciding whether to recommend them for final approval by the federal government. Open enrollment for 2016 plans will start November 1, 2015.

In June, the Department will host public information sessions detailing the health care provider networks likely to be available to New Hampshire residents in 2016 through the various health insurance plans offered on the Marketplace.

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. For more information, visit www.nh.gov/insurance.

Governor Hassan’s Statement on House Budget Vote

CONCORD – Governor Maggie Hassan today issued the following statement on the budget vote by the New Hampshire House of Representatives:

“In amending the House Finance Committee-recommended budget that already hurt families, undermined business growth and took our economy backward, Republicans in the House of Representatives managed today to make a reckless budget even worse. Their wildly irresponsible budget includes drastic reductions to services that are critical to our people and businesses, further downshifting on local property taxpayers, the raiding of the dedicated Renewable Energy Fund, continued budget gimmicks that mislead people about what we actually are funding, and the depletion of our Rainy Day Fund, which threatens our state’s financial outlook and bond rating.

“We know that our people and businesses support strategic investments in critical priorities that help ensure a strong and healthy workforce pipeline, a modern transportation infrastructure, and safe communities, but this harmful plan makes significant reductions to higher education, aid to local communities, road and bridge projects across the state, and critical services for seniors, substance misuse, mental health, and people who experience developmental disabilities. And by ending our bipartisan health care expansion program, the House Republican budget would eliminate health coverage for more than 37,000 hard-working Granite Staters.

“Not only would these reductions downshift responsibility to local property taxpayers, but they have a significant impact on our people, businesses and economic future, affecting areas that are critical to the health and well-being of our people and our economic competitiveness. They would make higher education more expensive, threaten to shut down local road and bridge projects, place an additional strain on our corrections officers, and harm the health and well-being of our families and workforce.

“It is still early in the process of finalizing a fiscally responsible, balanced budget, and I urge the Senate to take a different approach and recognize that we must work across party lines to pass a responsible budget that supports the priorities that matter to our people, businesses and economy. Senate Republicans cannot follow the path of their House counterparts and simply cater to the most extreme members of their party at the expense of common-sense and fiscal responsibility. The families, businesses and hard-working people of the Granite State deserve better than that.

“Two years ago, we worked together to pass the most bipartisan budget in more than a decade, and we must build on that progress by doing the responsible thing and making a bipartisan investment in the success of our people, our businesses and our economy.”

Kuster Statement on Passage of Medicare Access and CHIP Reauthorization Act of 2015

Washington, DC – This afternoon, Congresswoman Annie Kuster (NH-02) released the following statement regarding the passage of the Medicare Access and CHIP Reauthorization Actof 2015, which would end the threat of harmful cuts to Medicare reimbursements and prevent millions of children from losing access to health insurance:

 

“Since taking office, I’ve made fighting to protect Medicare one of my top priorities. Today, I was proud to join an overwhelming majority of members from both sides of the aisle in passing legislation to replace the broken Sustainable Growth Rate formula – which threatened to prevent many Granite State seniors from continuing to see their own doctors – with a new model that protects access to care for our seniors, ensures cost-savings, and most importantly, helps support the sustainability of Medicare for generations to come. 

 

“This bill also included important measures to protect the Granite State’s most vulnerable: it will extend the Children’s Health Insurance Program (CHIP) for two years and prevent millions of children from losing access to health care, expand funding for Community Health Centers (CHC), and protect vital assistance for low-income seniors.

 

“This is not a perfect bill, and I will continue to fight for a long-term extension of the Children’s Health Insurance Program. But this legislation will help protect access to medical care for older Americans and shore up Medicare for future generations, and I look forward to working with my colleagues in the Senate to improve this bill and see it signed into law.”

After 5 Years Data Shows The ACA Is Working For Granite State Families

On 5th Anniversary of Affordable Care Act, Landmark Health Law is Covering More Families, Lowering Health Care Costs

CONCORD, NH – Today marks the fifth anniversary of the landmark health care law, the Affordable Care Act – otherwise known as Obamacare. Statement from Granite State Progress Executive Director Zandra Rice Hawkins:

“The Affordable Care Act has provided New Hampshire families and small businesses with the security and stability they need in health care coverage. More than 53,000 Granite State consumers have enrolled for private health care coverage through the ACA marketplace, and an additional 37,000 of our neighbors have signed up for expanded Medicaid and can now access preventive care instead of relying on emergency rooms which drives up health costs for everyone. The ACA, or Obamacare as it is known to some, is achieving its goal of providing quality, affordable health care coverage to more Americans and bending the health care cost curve that was previously wildly out of control.”

According to HHS, 70 percent of New Hampshire consumers who signed up on the marketplace qualified for an average tax credit of $244 per month. Reporters can access more information on the impact of the Affordable Care Act in New Hampshire here. HHS also announced that the ACA has reduced hospital uncompensated care costs across the country by an estimated $7.4 billion in 2014. A report detailing the economic impact of Medicaid expansion and the overall accomplishments of the Affordable Care Act over the past five years are available on the HHS website.

New Hampshire Democratic Party Chair Ray Buckley released the following statement on the 5th anniversary of the Affordable Care Act:
 

“Five years after the President signed the Affordable Care Act into law, it’s clear that the ACA is working here in New Hampshire.”

“To date, over 53,000 Granite Staters have enrolled in private coverage on New Hampshire’s Health Insurance Marketplace, not to mention the 37,000 Granite Staters and counting who have gotten covered through New Hampshire’s Medicaid expansion plan.”

“Thanks to the Affordable Care Act, New Hampshire’s workforce is healthier and stronger and we’re already seeing a decline in the costs of uncompensated care, saving money for individuals and businesses.”  

“It is unconscionable that five years later, Kelly Ayotte and Frank Guinta are still fighting to take away health coverage from tens of thousands of Granite Staters and repeal critical new consumer protections that are not only saving money, but also saving lives. In 2016, voters across New Hampshire will hold them accountable for their backwards health care policies and elect Democrats who will fight for middle class families and small businesses.”

NH Health Protection Program Is Working For NH Hospitals

Statement from Governor Hassan on New Hampshire Hospital Association Report on New Hampshire Health Protection Program

 

 

CONCORD – Governor Maggie Hassan today issued the following statement on the report from the New Hampshire Hospital Association demonstrating that hospitals have seen a reduction in inpatient, outpatient and emergency department visits from uninsured Granite Staters since the New Hampshire Health Protection Program was adopted:

 

“The reduction in inpatient, outpatient and emergency room visits by uninsured Granite Staters demonstrated in the New Hampshire Hospital Association report is another strong indication of the positive impact that our bipartisan health care expansion plan is having on our people and our economy. Because of the New Hampshire Health Protection Program, we are reducing uncompensated care costs and health care cost-shifting onto our families and businesses, insurance premium tax revenues are increasing, and more than 36,000 hard-working men and women now have the peace of mind and health and financial security that comes with quality, affordable health coverage. The New Hampshire Health Protection Program is strengthening the health of our workforce and boosting our economy, and I look forward to working with the legislature to maintain our commitment to our people, businesses, and the future of our economy through our bipartisan health care expansion plan.”

 

The full report from the New Hampshire Hospital Association can be found here.

 

 

Granite State Rumblings: Protecting Children’s Healthcare Programs Both State and Federal

DA-ST-86-05880

The Children’s Health Insurance Program, CHIP, is often hailed as a model of a successful children’s health care program. It covers 8 million children who are not eligible for Medicaid and whose families cannot afford private insurance. In fact, research has found that since the program’s launch in 1997, the uninsured rate among U.S. children has fallen by half, from 14 percent in 1997 to 7 percent in 2012. ~ Source: The American Public Health Association

From its inception CHIP has enjoyed a large measure of bipartisan support. After all, who wouldn’t support insuring kids? As part of the Affordable Care Act, CHIP was authorized through 2019, though its funding was only extended through 2015. While federal legislation has been introduced in both the House and Senate that would extend CHIP funding for an additional four years, given the state of national politics, its reauthorization this year has advocates and state governors worried.

Like Medicaid, the Children’s Health Insurance Program is funded jointly by the states and the federal government. Unlike Medicaid, CHIP insures children from families with higher income levels and comes with a significantly better federal matching rate. On average, the federal government pays 57 percent of the costs for Medicaid but 70 percent of the costs for CHIP.

How each state would be affected if CHIP is not renewed varies, since each state runs its program differently. Some states keep their CHIP programs wholly separate from Medicaid; other states have simply expanded Medicaid to encompass CHIP; still others operate a combination of the two depending on income levels.

The eight states that cover all CHIP recipients through Medicaid would see their federal assistance drop to Medicaid levels, costing them about $1 billion collectively, according to Georgetown University’s Health Policy Institute. Those states, which are politically diverse and include California, Maryland, South Carolina and New Hampshire, would be required to continue covering CHIP recipients because they’re a part of Medicaid, which is an unlimited entitlement program, not a limited block grant like CHIP.

The 14 states that operate totally separate programs, however, wouldn’t even have the benefit of funding reduced to Medicaid levels. Those states would have to pay the entire cost of the program, which would mean upwards of $5 billion. Since their programs are separate, these states are also not under obligation to continue covering CHIP recipients. For the remaining states, the budget implications vary wildly.

With federal funding for the Children’s Health Insurance Program set to expire in September, children’s health advocates are calling on policymakers to take action on behalf of the millions of children at risk of losing access to affordable and comprehensive care. ~ Sources: Governing the States and Localities, Georgetown University Health Policy Institute, First Focus.

GROWING UP GRANITE

The House Finance Committee has scheduled three public hearings on HB1 and HB2. These hearings provide an important opportunity for all Granite Staters to express the priorities, programs and services that they believe the state should be addressing and funding. Please turn out and offer your testimony to the members of the House Finance Committee. Taking two to three minutes to share your personal stories about the programs and services that support you and your family, that keep your children safe and healthy, that protect your aging parents, and help keep your community strong and vital are critical to help ensure that all Granite Staters have the same opportunities.

The first meeting will be held in Concord this Thursday, March 5th in Rep’s Hall from 4-7 p.m.

The second and third meetings will be held concurrently in Conway and Derry on Monday, March 9, from 5-8 p.m.

  • The Conway hearing will be held in the Kennet High School Auditorium, 409 Eagles Way, North Conway.
  • The Derry meeting will be held at Derry Town Hall, 14 Manning Street, Derry.

If you are unable to attend one of the hearings, then please consider sending your story to the committee via e-mail at: HouseFinanceCommittee@leg.state.nh.us

Here’s an editorial from the Concord Monitor that shows very clearly why your voice is needed at one of the Finance Committee hearings. New Hampshire cannot afford to leave federal funds on the table.

Editorial: Hold placed on federal grants is shortsighted
Sunday, March 1, 2015

Last week, the directors and staff of one agency after another, in a semblance of Edvard Munch’s famous painting The Scream, cupped their faces in their hands and moaned, “Oh no, we’re Kurked.” And if the fiscally conservative chairman of the Joint Legislative Fiscal Committee gets his way, thousands of low-income adults only recently insured under the state’s expanded Medicaid program will follow suit.

For the first time in memory, under Neal Kurk’s leadership, the fiscal committee placed a hold on millions of dollars in hard-won federal grants. The decision will delay some awards, and depending on the committee’s decision, potentially result in a decision not to accept some federal largesse. The number of holds is unprecedented and shortsighted.

State agencies and employees, hoping to meet needs they fear won’t get funded any other way, put a lot of effort into writing grants and securing outside funding. If they succeed only to learn that the committee, or down the line the Executive Council, declines to accept the money, willingness to go the extra mile to find outside money will wane. New Hampshire, which at about 71 cents on the dollar already gets back less of its federal tax payments in federal spending than almost every other state, will become even more the donor state.

Kurk believes the decision to accept federal funds should be made not grant by grant but in the context of the state’s budget process. But New Hampshire is one of a minority of states that still uses a biennial budget. That could lead to inordinate delays in decision-making and the provision of the services the grants were meant to meet.

What Republicans who agree with Kurk really fear is a stampede of agency-accepted Trojan horses, gifts that could commit the state to additional spending. As Senate President Chuck Morse told Monitor State House reporter Allie Morris, taking free money to buy a fire truck is one thing, but who will pay to staff it, fuel it and insure it?

Meanwhile, for want of a fire truck, the barn is lost.

The committee is holding up money that would pay to collect information on violent deaths in the state and, at a time when opioid drug use and overdose deaths are epidemic, an investigator for the state’s drug task force. Other grants on hold were awarded to promote child safety, improve mental health services and help schools develop emergency plans.

Whatever the ultimate fate of the grants, the committee’s hold on them will do less harm than a goal its Republican members hope to achieve: a refusal by the majority party to reauthorize the state’s decision to expand Medicaid to serve low-income adults who aren’t disabled, even though the federal government will pick up 90 percent of the tab.

That decision would cancel coverage for more than 20,000 newly insured residents and make it far harder for them to get non-emergency and preventive health care. That, in our view, is misguided to the point of being immoral. Virtually every other advanced nation considers access to health care a right, not a societal luxury.

The Republican goal, if met, will also mean the loss of more than $300 million per year in federal funds, assuming even more of those eligible sign up under expanded Medicaid. That’s money that won’t be providing health care for low-income New Hampshire residents and good-paying jobs for the people who provide their care.

Looking a gift horse in the mouth and saying “No” is one thing. Hay, after all, can get expensive.

But it’s quite another if that “No” means plowing less land and going hungry or freezing to death on the long walk to the doctor’s office.

Five Companies Compete On The NH Healthcare Exchange

NH Insurance Department Issues Updated List of Health Care Provider Networks
2015 Marketplace to Feature 5 Insurance Companies and a Range of Networks, Plans

Concord, NH ­– The New Hampshire Insurance Department has updated its listing of health care provider networks that will be available through 2015 insurance plans sold on the federally facilitated New Hampshire Health Insurance Marketplace.

The updated network information details the service area of each network as well as the participating hospitals. It also includes a list of Essential Community Providers (ECPs) in each network: The Affordable Care Act requires insurance companies offering plans on the Marketplace to include in their networks “a sufficient number and geographic distribution of providers that serve predominantly low-income, medically underserved individuals.”

Five insurance companies will offer 2015 plans to New Hampshire residents through the Marketplace in New Hampshire: Anthem Blue Cross and Blue Shield; Assurant Health (Time); Harvard Pilgrim Health Care; Maine Community Health Options; and Minuteman Health.

“New Hampshire residents will have a variety of networks and plan designs to choose from when they visit HealthCare.gov beginning November 15,” said New Hampshire Insurance Commissioner Roger Sevigny. “We are pleased that residents will have such a range of choices, and we encourage each consumer to look closely at the options and choose a plan that meets his or her unique needs. Help is available at no cost in the form of in-person assisters and insurance agents and brokers.”

 New Hampshire residents who would like assistance may visit CoveringNewHampshire.org/get-help to view a list of the free help available: in the form of federally funded “in-person assisters,” who are trained to aid residents in navigating the HealthCare.gov website, and from those insurance agents and brokers in New Hampshire (also known as producers) who are licensed by the Insurance Department to sell insurance and who also have been certified by the federal government to assist Marketplace users.

The network information is available on the Insurance Department website: http://www.nh.gov/insurance/legal/documents/pres_updated_network10.28.14.pdf.

People who wish to determine whether a particular doctor is included in any health care provider network should visit the insurance company’s website to view a more detailed list. New Hampshire residents are encouraged to contact the Insurance Department’s Consumer Services division at (603) 271-2261 with any questions.

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. For more information, visit www.nh.gov/insurance.

Information for NH Residents on 2015 Health Insurance Marketplace

NH Insurance Department Issues First in a Series of Consumer Guidance

Concord, NH ­– The New Hampshire Insurance Department offers information to state residents who plan to purchase health insurance in the individual market for 2015, including plans offered through the state’s federally facilitated Health Insurance Marketplace (www.HealthCare.gov).

“As the November 15 open enrollment date approaches, we want New Hampshire citizens who plan to buy health insurance through the Marketplace to be aware of their options as consumers,” said New Hampshire Insurance Commissioner Roger Sevigny. “The Insurance Department regulates all insurance offered to individual consumers in the state, including health insurance.  While we are not involved in enrollment for the Marketplace, we can offer guidance that will enable residents to make informed choices.  Our Consumer Services staff is also available to assist with issues that arise after people are enrolled in coverage.” 

More choices for New Hampshire residents and businesses in 2015:  

Just one company, Anthem Blue Cross and Blue Shield, offered health insurance plans on the federally facilitated New Hampshire Health Marketplace in 2014, its first year in operation. However, in 2015, New Hampshire residents using the Marketplace will have five health insurance companies – and many plans and health provider networks – to choose among:

  • Anthem Blue Cross and Blue Shield
  • Assurant (Time)
  • Harvard Pilgrim Health Care
  • Maine Community Health Options
  • Minuteman Health

All but Assurant also plan to offer health insurance on the federally-operated Small Business Health Options Program (SHOP) for New Hampshire, available to businesses with 50 or fewer employees.

For more information about these companies’ health provider networks, go to: http://www.nh.gov/insurance/legal/documents/pres_updated_network08.25.14.pdf.
More detailed plan comparison information will also be available soon on www.CoveringNewHampshire.org 

Another new option: New Hampshire Health Protection Program:

The New Hampshire Health Protection Program, New Hampshire’s new health program for low-income residents, began offering coverage on Aug. 15, 2014.  People whose income is below certain levels (about $16,000 for an individual or $32,000 for a family of four) can qualify for no-cost or very low-cost health coverage.  More information is available from the NH Department of Health and Human Services: http://www.dhhs.nh.gov/ombp/nhhpp/.

People who are eligible for the New Hampshire Health Protection Program may not continue to receive federal tax credits in 2015. They should go to www.HealthCare.gov between Nov. 15 and Dec. 15 to cancel any 2015 Marketplace coverage and tax credits. 

Open enrollment – be sure to check your options, even if you’re already covered:

For 2015 individual plans, open enrollment begins Nov. 15, 2014 and ends Feb. 15, 2015. These dates apply to all individual health insurance plans, regardless of whether they are purchased through the Marketplace (www.HealthCare.gov). New Hampshire residents buying individual market coverage will not be able to buy 2015 coverage or change their 2015 plans after Feb. 15, 2015 unless they have a change in circumstances, such as changing jobs, getting married, or having a baby.

Coverage for 2015 plans can begin as soon as Jan. 1, 2015 (for those who sign up by Dec. 15, 2014).

Open enrollment is a resident’s opportunity to check the Marketplace to see whether there is a new plan that costs less, has a more suitable network, or has better cost sharing or prescription drug coverage.

New Hampshire residents who had coverage in 2014 should watch their mail for a renewal letter from their insurance company that explains their options and timeframes for renewal. People who bought health coverage in 2014 will be renewed on their current plan, or one that is similar, if they take no action.

Those who bought 2014 coverage on www.HealthCare.gov also will receive a notification from the Marketplace about their specific options, including information about any tax credits.  For most people receiving tax credits, the credits also will continue at the same level if they take no action.

Automatic renewal may not be the best choice, especially for people receiving tax credits:

  • Tax credit amounts are based on income and family size, but also on the pricing of plans available for that calendar year (2nd lowest cost silver plan).
  • Those residents receiving tax credits should check their options to be sure they are getting the assistance for which they are eligible, and that their tax credit amount is based on the most current information.

COMING SOON: Where can I get help with renewal and enrollment questions?

The New Hampshire Insurance Department’s mission is to promote and protect the public good by ensuring the existence of a safe and competitive insurance marketplace through the development and enforcement of the insurance laws of the State of New Hampshire. For more information, visit http://www.nh.gov/insurance

Granite State Rumblings: Medicaid Expansion Helps Former Foster Kids Receive Healthcare Till Age 26

As a former foster parent I was thrilled that when the Affordable Care Act was signed into law in March 2010 it contained a provision to expand Medicaid coverage to former foster children up to age 26. Here’s what the law states:

Patient Protection and Affordable Care Act (ACA) Section 2004:
Medicaid Coverage for Former Foster Care Children

Beginning in 2014, states must provide Medicaid coverage for individuals under age 26 who were in foster care at age 18 and receiving Medicaid. Consistent with this rule, youth are eligible for Medicaid if they:

  • Are under age 26;
  • Are not eligible for and enrolled in mandatory Medicaid coverage; and
  • Were in foster care under the state’s or tribe’s responsibility and also enrolled in Medicaid under the state’s Medicaid state plan or 1115 demonstration (or at state option were in foster care and Medicaid in any state rather than “the” state where the individual is now residing and applying for Medicaid) at age 18 or older if the state’s federal foster care assistance under title IV-E continued beyond that age.

First Focus released a new SPARC brief last week Former Foster Youth: An Update on the State Option and State Efforts to Ensure Coverage for All Young People Irrespective of Where They Aged Out of Care. This policy brief provides an overview of the new mandatory Medicaid coverage for former foster youth under the ACA, highlighting relevant Centers for Medicare and Medicaid Services (CMS) regulatory activity to date and additional concerns regarding the “state option,” summarizes state progress in taking up this option to provide coverage for former foster youth, irrespective of where they aged out of care, and makes recommendations for what more should be done to ensure access to coverage for every young person aging out of care.

Here are a few excerpts from that brief.

Why Health Coverage Matters

The expansion of Medicaid to cover youth previously in foster care to age 26 is a significant victory for this population because it provides access to critical health coverage for an especially vulnerable group of young adults. Children who have been abused or neglected often experience a range of physical and mental health needs, physical disabilities and developmental delays, far greater than other high-risk populations. For example, foster children are more likely than other children who receive health coverage through Medicaid to experience emotional and psychological disorders and have more chronic medical problems. Research suggests that nearly 60 percent of children in foster care experience a chronic medical condition, and one-quarter suffer from three or more chronic health conditions. Roughly 35 percent have significant oral health problems. In addition, nearly 70 percent of children in foster care exhibit moderate to severe mental health problems, and 40 to 60 percent are diagnosed with at least one psychiatric disorder.

Not surprisingly, youth aging out of foster care continue to experience poor health outcomes into adulthood, including high rates of drug and alcohol use, unplanned pregnancies and poor mental health outcomes. More than half of former foster youth report being uninsured, and more than one-fifth report unmet needs for medical care. Findings from the Midwest Study highlight that one-third of youth aging out reported two or more emergency room visits in past year, 22 percent were hospitalized at least once, 43 percent were uninsured, fewer than half had dental insurance, three-quarters of young women had been pregnant, and 19 percent received mental or behavioral health care in the past year.

Given that former foster youth have well-documented and often significant health care needs, these young people should be eligible for Medicaid coverage in any state, and once enrolled, should be able to retain their coverage irrespective of changes in residency.

Regulatory Guidance to Date on the ACA Provision for Former Foster Youth

In early 2013, CMS issued a number of documents to clarify how states should implement the new provision. On January 22, 2013, CMS issued a proposed rule in the Federal Register, which clarified CMS’s interpretation that a youth is only eligible for Medicaid coverage in the same state in which he or she was in foster care at age 18 and enrolled in Medicaid. While CMS gave states the option to cover youth under this group who were in foster care and Medicaid in any state at the relevant point in time, it did not require that they do so.

On July 15, 2013 CMS published the final rule, clarifying several outstanding issues, including that the new eligibility category of former foster youth are eligible for full Medicaid benefits including Early, Periodic, Screening, Diagnosis, and Treatment (EPSDT) up to age 21. On December 31, 2013, CMS issued a FAQ that clarified that it would approve state plan amendments8 to cover youth who were in foster care and receiving Medicaid when they turned 18 or aged out of foster care in another state – meaning that states could receive federal reimbursement for out-of-state foster youth if they choose to enroll them in Medicaid.

More recently, on August 24, 2014, CMS posted a State Highlights feature on Medicaid.gov focusing on the provision to enable former foster youth to keep their Medicaid coverage, and highlighting efforts in Idaho and Georgia to reach out to and enroll young people who have aged out of care.  It is noteworthy that CMS chose to highlight this provision and demonstrates that it is tracking implementation progress in states.

To date, only 12 states have taken up the option to extend coverage to youth who aged out in another state:

  • California
  • Georgia
  • Kentucky
  • Louisiana
  • Massachusetts
  • Michigan
  • Montana
  • New York
  • Pennsylvania
  • South Dakota
  • Wisconsin
  • Virginia (pending state plan amendment)

Unfortunately, with a majority of states opting to not cover youth aging out in other states, many young people will be left without essential medical coverage.

The expansion of Medicaid to cover youth previously in foster care to age 26 is a significant victory for this population. One of the most popular parts of health reform is coverage for kids up to age 26 on their parents’ insurance plan. This new mandatory coverage for former foster youth has the potential to provide equal treatment in cases where the state steps in to care for children removed from the home as a result of abuse or neglect. It is critical that we remove any barriers to coverage for young people aging out of care, and that includes removing the eligibility restriction tied to residency.

While we hope that both Congress and CMS will consider taking steps to resolve this concern, it is also critical that state advocates, policymakers and other stakeholders continue to work to push states to take up the option to cover all former foster youth residing in their state.

GROWING UP GRANITE

Last week the Census Bureau released the Supplemental Poverty Measure for 2013.  The SPM extends the official poverty measure by taking account of many of the government programs designed to assist low-income families and individuals that are not included in the current official poverty measure.

Our friends at the NH Fiscal Policy Institute delve into the Census Bureau release in their new Common Cents blogpost and find that the New Hampshire poverty rate increases with the Supplemental Measure:

Ask any scientist or researcher and they’ll tell you: measurement matters. While one might commonly think of a biologist or an astronomer calibrating instruments to arrive at more accurate observations, that truth extends to the social sciences as well, where better, more robust measures can yield new insights into economic conditions.

For instance, a more comprehensive measure of poverty – known as the Supplemental Poverty Measure (SPM) – demonstrates that New Hampshire’s poverty rate is much higher than typically thought. New SPM data released last week by the US Census Bureau indicate that New Hampshire’s poverty rate for the 2011-2013 period was 10.5 percent, 2.2 percentage points higher than the rate under the traditional, official poverty measure for that time frame. It also suggests that approximately 138,000 Granite Staters lived in poverty during that period, an increase of roughly 29,000 people or nearly 27 percent over the number living in poverty under the traditional measure.

Economists and other experts have long understood that that official measure of poverty suffers from significant shortcomings. It both fails to account properly for all of the costs people face and neglects the fact that certain parts of the country can be far pricier than others. The SPM attempts to address these fundamental flaws and to assess more precisely the resources available within families to meet basic needs, counting not just income, but the cash value of benefits like nutrition assistance or housing subsidies.

These adjustments have a distinct impact in New Hampshire, which was one of just 13 states where the poverty rate was higher under the SPM than under the official measure. In contrast, some 26 states enjoyed lower poverty rates under the SPM, while, in the remaining 11, there was no statistically meaningful difference between the two measures. The reasons for the differences among the states are uncertain, given the data available from the Census Bureau, but the agency’s analysis of national level data reveal that out-of-pocket medical expenditures as well as work expenses can drive up poverty rates under the SPM. It may also be telling that many of the 13 states with heightened rates are concentrated in the Northeast, which tends to have a higher overall cost of living.

The latest Supplemental Poverty Measure data, when combined with traditionally measured poverty rates that are still higher than pre-recession levels in New Hampshire, suggests that much remains to be done to ensure greater economic security for all Granite Staters.

  • Matt Murray 2122Netroots

    Please #VoteForMatt to win a scholarship to attend Netroots Nation #NN15

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