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April 26, 2017

Changes To Federal Insurance Plans Could Hurt Families Of Chronically Ill Kids

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Kids with chronic conditions are especially vulnerable to health insurance changes, relying as they often do on specialists and medications that may not be covered if they switch plans. A recent study finds that these transitions can leave kids and their families financially vulnerable as well.

The research, published in the April issue of Health Affairs, examines the spending impact of shifting chronically ill kids from the Children’s Health Insurance Program (CHIP) to policies offered on the marketplaces established under the federal health law. The out-of-pocket costs to these children’s families would likely rise — in some cases dramatically — following a change to marketplace coverage, the study finds.

The research comes at a time when health insurance issues are on the front burner in Congress. Republican lawmakers are pushing for fundamental changes to the marketplaces and to the Medicaid program. At the same time, Congress must soon decide whether to extend CHIP when its funding ends in September.

Together the state-federal Medicaid and CHIP programs insure 46 million low-income children. CHIP covers kids whose family income is low, but too high to qualify for Medicaid.

The eligibility levels vary by state. Half of states set the upper income eligibility limit at 255 percent of the federal poverty level or higher (about $52,000 for a family of three). Both programs provide comprehensive coverage for children with little or no out-of-pocket cost to families.

CHIP is much smaller than Medicaid, with more than 8 million children enrolled. Roughly 2 million have one of six chronic health conditions, including asthma, attention deficit hyperactivity disorder, diabetes, epilepsy, mood disorders and developmental disorders such as autism, according to the study.

Using data compiled from state CHIP programs and marketplace plans for 2016 and health care use data from the federal Medical Expenditure Panel Surveys from 2008 to 2013, researchers simulated the annual out-of-pocket costs for children with these six chronic conditions if they were enrolled in CHIP versus one of the plans sold on the marketplaces operated by the federal government.

Read more at NPR.org

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