Tag Archives: Colorado Child Health Plan Plus

Colo. Dept. of Health Care Policy & Financing Recycles Child Poverty Statistics

The Colorado Department of Health Care Policy and Financing is ill-served when it bases its strategic plans on ancient, and incorrect, data from advocacy organizations.
In its narrative response to the Joint Budget Committee on January 4, 2012, on page 9 HCPF informs the Committee that

All states are facing similar challenges to manage more clients with fewer resources. Colorado, however, has the fastest-growing child poverty rate in the nation. The child poverty rate has climbed by 72% since 2000, according to KIDS COUNT in Colorado, an annual report by the Colorado Children’s Campaign.

As the Independence Institute showed in 2008, the large increase in child poverty claimed by the Colorado Children’s Campaign is a statistical artifact. The statistical sample used to generate poverty rates in 2000 was restricted to Colorado counties that have historically had relatively low child poverty rates. When counties with historically higher rates of child poverty were added in 2006, estimated child poverty jumped and advocates declared a crisis.
The Campaign is not a neutral policy group. It has long been closely affiliated with the Annie E. Casey Foundation. Annie E. Casey has long advocated for more government involvement in the lives of children. Among other things, the Campaign was a participant in the Finish Line project, a national project partially funded by an organization with a longer-term goal of informing and “advancing federal policy to cover all children.”

If the goal is more government involvement, and one implicitly assumes that poor families cannot raise children properly, what better way to foster more government involvement than to produce and harp on data showing that child poverty is increasing?

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Why Obamacare’s Medicaid Expansion Will Reduce Health Care Access

In the Atlantic, Avik Roy writes:

Chapin White of the Center for Studying Health System Change has published an important new paper in Health Services Research, a journal of health economics, which suggests that a critical part of the Affordable Care Act–its expansion of Medicaid coverage to 16 million more Americans–may actually reduce those individuals’ access to health care. …

Believe it or not, physicians even do better caring for the uninsured than they do caring for Medicaid patients. Two MIT economists, Jonathan Gruber and David Rodriguez, have found that three-quarters of physicians receive lower fees for serving Medicaid patients than they do for the uninsured, because many people without health insurance are still able to pay out-of-pocket for routine health expenses.

How?  Medicaid notoriously underpays doctors, so Medicaid patients have trouble accessing them. When Medicaid eligibility expands, many newly eligible people drop “private” health plans to enroll.

Read the whole post: Why Obamacare’s Medicaid Expansion Will Reduce Health Care Access – The Atlantic.

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Filed under coverage isn't care, Medicaid/Medicare/SCHIP

Hickenlooper’s veto of SB 11-213 insults low-income parents

The Boulder Daily Camera published my article criticizing Governor’s veto of Senate Bill 11-213. Here are the first and last paragraphs:

“Let them drink beer, while you pay.”  This is how Colorado taxpayers should interpret Governor Hickenlooper’s recent veto of Senate Bill 213.  For some families, SB 213 would have increased the Child Health Plan Plus (CHP+) enrollment fee to $20 per month. This is what the lowest income U.S. households spend on alcohol.

CHP+ officials will soon propose changes to CHP+ fees and possibly co-payments, which are also extremely low. Maintaining current fees would not only be an injustice to taxpayers, but also an insult to eligible parents. The fees imply that parents value enjoying life’s amenities more than their own children’s health.

Read the whole article in the Boulder Daily Camera.

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Filed under Colorado health care, Medicaid/Medicare/SCHIP

Gov. Hickenlooper wrong to veto Colorado SB11-213

The Denver Post published my letter to the editor criticizing Governor Hickenlooper’s veto of Senate Bill 11-213:

Re: “Hick’s reason for veto makes sense,” June 2 editorial.

Gov. John Hickenlooper was wrong to veto Senate Bill 213, which would have increased Child Health Plan Plus premiums for families earning more than twice the federal poverty level. Enrolling one child costs just $25 per year. A Post editorial asked if it was unfair for SB 213 to raise the fee to $20 per month. It’s fair. According to the latest Consumer Expenditure Survey, the poorest U.S. households spend on average more than $150 per month on alcohol, tobacco, sweets and entertainment.

What’s unfair is that Colorado compels taxpayers to fund a program that allows eligible parents to value satisfying bodily appetites more than their children’s health.

This was a very short version of my longer article on the subject, which describes how programs like CHP+ crowds out private insurance. That is, parents stop buying it and sign up for the tax-funded product.  Read more:

Colorado Child Health Plan: Parents should value children’s health more than sweets and booze, Health Policy Solutions, May 17; Denver Daily News, May 20.

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Colorado SB 11-213: Parents should value children’s health more than sweets & booze

Would you donate to a charity that allows parents well over the poverty line to pay just $25 per year for their child’s’ medical insurance? What if many recipients previously paid for such insurance themselves, and spend hundreds of dollars a year on booze, sweets and entertainment?  If you pay Colorado taxes, you’re forced to fund such a charity – the state-run “Child Health Plan Plus” (CHP+).  Senate Bill 11-213, which is awaiting the governor’s signature, would increase CHP+ enrollment fees for the wealthiest of eligible households, and rightly so.

Read the rest of this article at HealthPolicySolutions.org: Parents should value children’s health more than sweets and booze

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Colorado SB 11-213: Parents can afford higher child health plan fees

Colorado parents earning up to 250% of the Federal Poverty Level (FPL) are eligible for the tax-funded Child Health Plan Plus. Enrollment fees are $25 per year for one child, and $35 per year for two or more children. The Denver Post reports that  Senate Bill 11-213 would increase the enrollment fees for households with incomes between 205% & 250% of the FPL: $20/month for one child, $10/more for each additional child with a $50/month limit.

[History of votes on this bill; May 1 Denver Post article on its status]

Can parents in this income range afford this?  Data from the Bureau of Labor Statistics says yes.  As I’ve written before:

The 2009 [Bureau of Labor Statistics] Consumer Expenditure Survey data suggests that some Medicaid recipients and parents with kids in CHP+ can afford more. On average, the lowest income households, less than $5,000, spend almost $1,900 on sweets, alcohol, tobacco, and entertainment. (That’s $156 per month) Oddly, households with incomes between $5,000 and $10,000 spend less on these items – around $1,400 ($113/month).

More details: If you look at the BLS data, the average number of people in a “consumer unit,” i.e., household or family is 2, with on average half a person under 18.  Then look at the CHP+ eligibility rules for a family size of 2. The maximum income such a family can have is $3,065 per month, or about $37,000 per year.

Now look back to the BLS data, which splits households according to $10,000 income increments, and look at the spending habits for households with the bracket below $37,000 per year: $20,000 – $30,000 per year. Note that looking at spending of families in this income range underestimates the spending of higher-income CHP+ eligible families with income betweeen $30,000 and $37,000.

For this group ($20,000 – $30,000 per year.), the total spending on alcohol, tobacco, candy, and entertainment is $2,287 per year, or $191 per month.   Such households have, on average half a person under age 18, which means that about half do not have kids.  For sake of argument, say that the childless households account for, say, 3 times as much spending as those with kids.  Even in this case, the spending by households with kids is $95 per month.

(See my calculations here.)

Moreover, the Congressional Budget Office reports that 77% of children in families with incomes between two and three times the FPL have commercial (non-government) health plans.  For the lower-income bracket, between one times and twice the FPL, the rate is 50%.  The CBO report also concludes that the State Health Insurance Program (S-CHIP) crowds out private insurance:

for every 100 children who enroll as a result of SCHIP, there is a corresponding reduction in private coverage of between 25 and 50 children.

(Colorado’s “Child Health Plan Plus” is Colorado’s version of S-CHIP.)

A study co-authored by MIT economist (& past Obama Administration consultant) Jonathan Gruber estimates that SCHIP’s crowd out level is 60%. Or as Michael Cannon puts it, S-CHIP  covers “four uninsured Americans for the price of ten — a lousy deal even by government standards.”

So when people object to SB 11-213 by saying parents will drop enrollment, do they say what happens next?  Some buy insurance themselves. After all, according to the CBO, between 50% and 77% of people with incomes between 205% and 250% of the FPL already buy commercial health plans for their kids.

The enrollment fees of Senate Bill 11-218 are similar to New Hampshire’s “Healthy Kids” program, which charges monthly fee $32 for households between 185%-250% FPL). As I’ve noted before, the program’s co-pays are also higher, and more reasonable.

See also: The Citizens’ Budget by the Independence Institute, health care policy section (page 75 of pdf for CHP+).

Recent news: Last week the Denver Post reported that “Deal on Colorado children’s health care bill faces last-minute snag.”

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Filed under Colorado health care

Feds reward Colorado Medicaid for increasing gov’t dependency

Last week’s Denver Business Journal reports

Colorado received a $13.7 million award from the federal Centers for Medicare and Medicaid Services Monday for making changes to its Medicaid enrollment policies that led to a big increase this year in the number of children enrolled in the public health insurance program.

Read more: Colo. Medicaid program gets $13.7M.

So the feds reward the Colorado government for expanding government dependency.  The National Bureau of Economic Research estimates that “for every 100 children who are enrolled in public insurance, 60 children lose private insurance.”

Worse yet, programs like SCHIP discourage parents from advancing their careers and earning higher wages because they might forfeit their government benefits. Parents are thus caught in a “low-wage trap.” *

Instead of promoting government dependency and crowding out non-government insurance products, Colorado Medicaid and S-CHIP should support self-reliance, private charity, and a competitive insurance marketplace.  One simple step would be to increase enrollment fees is the Colorado Children’s Health Plan Plus.

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* I’ve quoted my own letter to the editor on this subject from two years ago.

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