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SPITZER CONTINUES EFFORT TO REVERSE FEDERAL ROLL BACK OF CHILDREN’S HEALTH INSURANCE PROGRAM

Following a decision today by the U.S. Department of Health and Human Services (HHS) rejecting the state’s efforts to expand health insurance to cover every uninsured child in the state, Governor Eliot Spitzer was joined by New York’s congressional delegation in calling on President Bush to roll back the action.

“Today’s federal decision is a cruel blow to New York’s uninsured children, and to uninsured families across the country,” said Governor Spitzer. “I urge President Bush to do the right thing to protect our nation’s children. New York is prepared to pursue legal action to challenge these rules and step up its efforts in conjunction with our congressional delegation and with other states to ensure that health care remains affordable and accessible to every family.”

On Monday, the Governor is scheduled to meet with the delegation to discuss the next steps in this effort. Possible actions include legal action or legislative intervention to challenge the decision by HHS which denied New York’s request to expand its Child Health Plus eligibility from 250 percent of the federal poverty level to 400 percent – expanding the eligibility and access to health insurance to an additional 70,000 children.

The meeting follows the release today of a letter signed by 25 members of New York’s congressional delegation calling for the Centers for Medicare and Medicaid Services (CMS) to rescind the requirements imposed on states wishing to extend eligibility requirements for the State Children’s Health Insurance Program (SCHIP).

The federal decision was based on arbitrary rules that are not supported by the statute that established SCHIP, defies congressional intent and establishes unreasonable, harmful health policy for the United States.

The grounds for denial of New York’s request were based on new rules announced on August 17 by the federal CMS that apply to all states. They are:

• New York could not prove that 95 percent of children below 200 percent of the poverty level were enrolled in Child Health Plus. New York is one of the states with the highest participation rates – at 88 percent. No state has reached a 95 percent enrollment rate;
• New York’s plan did not require a child to go without health insurance for 12 months – with no exceptions – before becoming eligible for Child Health Plus.(J New York’s plan to require a six month crowd out period, with exceptions, is similar to many other states that have received federal approval for expansions above 200 percent of the federal poverty level; and
• New York’s co-premium requirements were too low because they were not comparable to the private sector or as high as five percent of family income. New York’s co-premium requirements are comparable to amounts set by other states and previously approved by CMS.

Health Commissioner Richard F. Daines, M.D., said: “The requirement to have children remain uninsured for 12 months is unacceptable. New York’s approach to prevent ‘crowd out’ is effective and compassionate. New Yorkers know that children lose their health insurance most often when a parent dies or loses a job, that’s why waiting 12 months without exceptions is wrong. The pathway to healthy development starts by providing access to regularly scheduled check-ups, immunizations, and early developmental screenings.”

A copy of today’s letter from members of New York’s Congressional delegation is attached.