Children waiting to enroll in state health insurance programs have grown 93 percent; Immediate action urged.

By Amy Lambiaso
STATE HOUSE NEWS SERVICE

STATE HOUSE, BOSTON, APRIL 8, 2004….The number of children waiting for health insurance in Massachusetts has risen by 93 percent to 12,328 during the last five months, advocates said Thursday, and $7 million will be required next year to resolve the problem.

Health care supporters joined democratic lawmakers on Thursday to push for an increase in funding to the Children’s Medical Security Plan (CMSP) and the Healthy Start pre-natal care program, and a reduction in the premiums for CMSP and MassHealth, applied in November 2003 to keep the programs afloat. In the administration’s fiscal year 2005 budget proposal, Gov. Mitt Romney level funded CMSP at $11.874 million and Healthy Start at $6.2 million.

CMSP provides health insurance to children in families that earn more than 200 percent of the federal poverty level – $36,800 for a family of four – or are not eligible for other types of health insurance.

The state in November introduced new premiums of $10.50 per child for families earning between $27,600 and $36,800, and raised the premium to $45.32 per child for families earning up to $73,600.

Families with children enrolled in MassHealth were also required to pay new premiums of $12 per child in November, an unsustainable amount for the 5,000 children who have left the program, advocates said. There are currently more than 433,000 children enrolled in MassHealth.

According to Health Care For All, there are currently 20,600 children enrolled in CMSP with 12,328 on the waiting list. After opening the program in 1996, the state capped enrollment for CMSP in 2002 at 26,000. Since then, the state has not opened enrollment for more children to join, causing the number on the waiting list to rise while enrollment continues to drop.

“We didn’t think it would get as bad as it has,” said John McDonough, executive director of Health Care For All.

Roseanne Pawelec, spokeswoman for the Department of Public Health, which administers CMSP, said the governor has fought to maintain the program’s funding and was “successful in having premium changes made to ensure the viability of this program this year given the fiscal constraints to preserve this important program,” she said.
According to a 2002 Division of Health Care Finance and Policy report, 3 percent of Massachusetts children do not have health insurance, compared with the 12 percent national average.

The waiting list can be eliminated with a $19 million appropriation in next year’s budget, said Lucy Meadows, manager of the Children’s Division at Health Care For All. And legislative leaders say the money is available if budget writers re-prioritize their spending.

“I’m angry,” said Sen. Mark Montigny (D-New Bedford). “Not only because the numbers speak for themselves, but because there’s not enough outrage about this.”

Montigny said the state could afford to add $7 million into CMSP’s budget by using money from the Federal Medical Assistance Percentage (FMAP) – federal reimbursement for Medicaid expenditures. The state is expecting roughly $4 billion in FMAP this year, a 50 percent reimbursement for the projected $7.9 billion in Medicaid spending, said Tricia Spellman, chief financial officer for the Executive Office of Health and Human Services.

In addition, the state received enhanced FMAP reimbursement this year totaling $285 million through a federal economic stimulus package. That money, along with the $4 billion is deposited directly into the state’s general fund and has already been accounted for in Romney’s House 1 budget, Spellman said.

“We should be saying that we will not pass a budget and will not sign a budget without this being reversed,” Montigny said. “That’s what the standard should be. We have hundreds of millions of dollars available to pay for it and no one should be saying we can’t afford it.”

Montigny said he is “cautiously optimistic” that the House and Senate will increase CMSP funding, and said he has been getting “positive signals” from Senate budget writers about the possibility. The House is due to release its budget proposal next Wednesday, with the Senate releasing its response mid-May.

“We were hopeful that this spring we could begin bringing additional children onto enrollment,” Pawelec said. “But in the last month the turnaround has been extremely sluggish. This can change at any moment though, and we’re going to be looking for opportunities to do that in the coming weeks.”

But for Rosa Love, a Revere mother with two children on the CMSP waiting list, that answer isn’t good enough. With tears streaming down her face, she told lawmakers and advocates about a recent incident where she had to take her son to the hospital for an allergic reaction. Without health coverage for her son, Love said she could hardly afford to pay the $170 charge for visiting a doctor.

“I’m here to tell you people, whoever is in charge of this stuff, that there are real kids out there, and there cannot be a black and white – there has to be a gray,” Love said. “These kids need insurance.”
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