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03-10-2008

Testimony Before House Finance Committee - Mary Wachtel

Good morning Chairman Hottinger, Ranking Member Skindell, and members of the House Finance Committee. My name is Mary Wachtel and I am the Director of Health Policy for Voices for Ohio’s Children and a member of the Campaign to Protect Ohio’s Future. I am here today to speak briefly in favor of continuing Ohio’s strong commitment to provide access to affordable health care for our state’s uninsured children.

Access to quality health care makes an important difference for growing and developing children. Research confirms that children with health insurance are more likely to obtain preventive care¹, to have a medical home or regular source of ongoing care², to participate in physical activities³, and to have better health outcomes than uninsured children⁴.

Ohio does many things right for children’s health and that commitment has paid off. Ohio’s past coverage expansions have helped decrease the percent of uninsured children in Ohio from 9.8% in 1998 to 5.4% in 2004⁵: a remarkable achievement given the growth in Ohio’s poverty rate and annual average unemployment rate⁶ as well as rising health costs and declines in employer-based coverage during the same time period. Of all our health reform efforts in recent years, expanding coverage to children through Medicaid and SCHIP has been the most successful and efficient.

Recognizing that success, you and your colleagues included several Medicaid expansions in H.B. 119, including:

Allowing children aging out of foster care to keep Medicaid coverage until age 21 (implemented January 2, 2008),
Increasing Medicaid eligibility for pregnant women to 200% of the Federal Poverty Level (FPL) (implemented January 2, 2008),
Allowing workers with disabilities to buy into Medicaid coverage,
Establishing a Children’s Buy-In program for children who cannot access health coverage due to a health condition, and
Expanding Medicaid/SCHIP for children from 200% to 300% FPL—in fact, the initial proposal for this expansion came from a member of this Committee, Representative Jimmy Stewart.

Ohio’s leaders have agreed across partisan lines that solving the problem of uninsured children is both politically and fiscally feasible. However, since these initiatives were passed in H.B. 119, Ohio, along with other states, has been stalled by a new directive from The Centers for Medicare and Medicaid Services (CMS) that is preventing full implementation of the Medicaid/SCHIP expansion to 300% FPL. Unfortunately, this means that 35,000 Ohio children without health insurance in this income level are still waiting. Voices and the Campaign support Ohio’s efforts to move forward with covering kids up to 250% FPL⁷—the income level which CMS indicates they will allow—and to explore other options for covering kids between 251%-300% FPL.

We know that here in Ohio and across the country, Medicaid and SCHIP are the most successful, cost-effective way to cover our uninsured children. We also know that Ohio is also facing a tougher-than-expected economic climate. We commend this body and Governor Strickland for your firm commitment to covering more children. Working together in 2008, we can help Ohio reach the finish line of children’s health coverage.

Thank you. I am happy to answer any questions you may have.

Mary D. Wachtel
Voices for Ohio’s Children, Columbus Office
510 E. Mound Street, Suite 200
Columbus, Ohio 43215
614.225.9073
mwachtel@vfc-oh.org

¹Ku, Leighton and Sashi Nimelendran, Center on Budget and Policy Priorities, Improving Children’s Health; A Chartbook About the Roles of Medicaid and SCHIP (January 2004), citing Kenney, et al, 2003, analyses of National Survey of America’s Families.
²Ibid, citing CDC 2003b, analyses of 2001 National Health Interview Survey.
³Sicker and Poorer, citing Keane, et al, Pediatrics. The Impact of a Children’s Health Insurance Program by Age, 1999. November; 104(5): 101-7.
⁴Institute of Medicine, Hidden Costs, Value Lost: Uninsurance in America, National Academy of Sciences (2003).
⁵Ohio Department of Job and Family Services, March 2005. Health Insurance Coverage in Ohio, 2004: The Roles of Public and Private Programs in Assuring Access to Health Care: Results from the Ohio Family Health Survey, page 4.
⁶Ohio Department of Job and Family Services, March 2005. Medicaid and Its Relationship to the Low-Income Population: Does Medicaid Serve Everyone Policymakers Intended? Results from the Ohio Family Health Survey, page 3.
⁷ODJFS officials filed an amended plan with CMS on February 15, 2008 to expand Medicaid/SCHIP eligibility for children to 250% FPL.

Voices for Ohio's Children is a non-partisan group of public, not-for-profit and private sector organizations and individuals who share a mutual concern about improving the well-being of our community’s children and their families. Through a collaborative effort and a collective voice, Voices promotes improvements in the well being of our community's children and their families.