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Expansion of health coverage for children and parents will likely be in the forefront of health care policy debates in Washington and state capitols in 2007. With states generally in better financial shape since the fiscal crisis earlier in the decade, many have expressed interest in improving access to their Medicaid and State Children's Health Insurance Programs (SCHIP). According to a new Kaiser Foundation Survey, a new federal law requiring proof of citizenship and identity for beneficiaries is threatening state efforts to provide health coverage for uninsured low-income children and their parents through Medicaid and the State Children Health Insurance Program. The 50-state survey, Trends in Access to Mediciad and SCHIP Coverage, showed that one-third of the states increased access to health coverage and that none cut eligibility for Medicaid and SCHIP for the first time in four years. But the expansion slowed down sharply and even went into reverse in some cases after July 1, the effective date of the new standards mandated by the Deficit Reduction Act of 2005, which introduced the new citizenship documentation requirement to determine eligibility for Medicaid services. Children, including newborns, are subject to the proof of citizenship requirements. Kaiser Foundation analyst Donna Cohen Rothman said that at a time of "renewed enthusiasm" for providing coverage, the citizenship and ID requirements "placed restrictions" on state initiatives to recruit additional beneficiaries through simplified enrollment procedures. Virginia, Wisconsin, Iowa and several other states actually saw their enrollments decline in the last six months of the year, Cohen Rothman said. |