Waiving the CHIP waiting period

PA Congressman says an affordability exemption will prevent kids from taking a healthcare hiatus.

PA Congressman says an affordability exemption will prevent kids from taking a healthcare hiatus.

Listen: [audio:090522teschip.mp3]

Congressman Patrick Murphy says the legislation was inspired by a single dad in his Bucks County district who was spending more than 15 percent of his income to pay for a group health insurance plan.

Murphy says families who spend more than 10 percent of their income on medical expenses should not be forced to put their kids on a health care hiatus while they wait to qualify for their state’s CHIP.

Murphy: It’s cheaper to allow these kids to get in SCHIP, overall if you have a kid who doesn’t have private insurance because his family can’t afford it, and then those kids get sick and have to go to the emergency room, costs are going to go up. That is not the most cost effective way.

Most states waive the CHIP waiting period when a parent loses a job, and some states let toddlers into the program immediately, but the rules vary. Murphy wants those waivers — and the affordability exemption for every state.

A Washington health policy group says the proposal is a modest — but timely — reform for families struggling with health costs.

Policy Analyst Jocelyn Guyer works for the Center for Children and Families. She says a few states already have the affordability exemption but not Pennsylvania.

Guyer: It’s a state decision, so it can be pretty random, and so you could be a kid in one state who’s subject to a waiting period and if you were just living across the border you’d be able to get coverage right away.

Most states ask low-income families to wait three to six months before enrolling in CHIP. That delay is meant to prevent people from dropping their private coverage in order to switch to the affordable public program.

Guyer says expanded access to CHIP could cost states more, but many recognize the increased need in a sluggish economy.

Guyer: While states are clearly in a tight spot and some of them are having to resort to cuts to a large extent, they are actually holding on to their coverage for children and in many cases actually expanding it.