To fully appreciate what Healthy Montana Kids has accomplished, remember the way things used to be:
- Montana Medicaid only covered children under age 6, and only in families with income below 130 percent of poverty.
- The Montana Children’s Health Insurance Program covered children from birth to 18, but funding was limited by biennial legislative appropriation. At one time, more than 1,300 children were on the waiting list.
- Montana’s income limit for CHIP eligibility was 175 percent of poverty level, one of the lowest among the 50 states.
- Montana researchers estimated that more than 35,000 children in our state had no health coverage in 2007. That number climbed during the Great Recession.
In 2008, Montana voters decided those children should be covered. After a campaign led by then State Auditor John Morrison, 70 percent of voters directed that a portion of state taxes paid by insurance companies be used to expand CHIP and children’s Medicaid.
As reported in the July 20 Gazette by Mike Dennison, Healthy Montana Kids now covers 107,500 kids – 37,500 more than were covered by CHIP and Medicaid when HMK launched in October 2009.
Eighty-eight percent of those children are enrolled in Medicaid, which now has an income limit of 143 percent of poverty ($28,300 for a family of three). Montana has been most successful at covering the lowest income children, those whose families have the least means to provide the preventive health care that children need to be healthier throughout their lives.
Children are eligible for CHIP when the family income is under 266 percent of poverty level ($52,600 for a family of three).
It’s not surprising that children’s Medicaid enrollment grew more than CHIP. Healthy Montana Kids made children through age 18 eligible for Medicaid, so families no longer have younger and older siblings split between Medicaid and CHIP.
Healthy Montana Kids also raised the profile of government-subsidized health care for Montana children. Hundreds of people in Montana health and children’s organizations trained to promote HMK and to assist parents in completing applications.
No longer is children’s health care enrollment capped; it is available to all Montana children whose families meet the income requirement.
HMK also cut red tape. The Montana Department of Public Health and Human Services created a single, brief application. DPHHS determines whether the child is eligible for CHIP, Medicaid or neither.
Thale Dillon, director of Montana Kids Count at the University of Montana, has been tracking children’s health data for years. She attributes the success of Healthy Montana Kids to several factors:
- The higher income limits.
- Strong publicity in media and marketing.
- Steam-lined application.
- Increasing DPHHS staff sufficiently to handle the higher volume of applications.
“They have done a good job publicizing that it exists and letting people know that their children may be eligible, even if they thought they weren’t eligible for Medicaid,” Dillon said.
The promotion of insurance under the Affordable Care Act last year also boosted Healthy Montana Kids enrollment. It increased from 90,000 in fiscal year 2012 to 107,500 this April. When parents checked out the insurance exchange, they also learned whether their children were eligible for Healthy Montana Kids.
In 2009, DPHHS set what then Director Anna Whiting Sorrell called “a lofty goal of getting 100,000” kids covered. Four and a half years later, that goal has been surpassed.
Adults still uncovered
Healthy Montana Kids is a success. Montanans should be proud of standing together for children’s health. They have removed the financial barriers that kept families from accessing care their children need.
Kids have HMK, older adults and disabled folks have Medicare and, if they are low-income, Medicaid, too. Now Montana needs to make health coverage accessible for parents and other adults 19 to 64. The solution will require changing Medicaid in some fashion to cover all low-income Montanans.