Subsidizing Health Insurance Premiums or Keeping Medicaid – Which is Best?

There are many creative ways that are being explored to help individuals and families come off of Medicaid and subsidize their payments for employer sponsored health insurance if it is available to them.  Utah is one of the states that will be working with Medicaid to have Medicaid help low-income families offset these premiums, as this would help people be able to buy their own insurance. 

The question is whether these individuals and families will be better off.  Will they actually have access to and actually be able to receive better care.  Advocates are asking whether or not individuals will not only be able to get the care they need, but also receive it without limits on copayments and deductibles. 

The plan that Utah is trying to put in place involves Utah’s Premium Partnership for Health Insurance (UPP) which presently provides up to $150 per family toward their premiums.  The problem is that employer-sponsored health plans are not available to everyone, so in these cases, this pan could seriously limit these individuals’ and families’ access to health care.  The aim is to provide coverage to about 5,000 adults and 1,000 children.

There are issues with this, however.  One issue is that if adults enroll in the plan, their children would have to be enrolled, and this would exclude them from the Children’s Health Insurance Program (CHIP).  The problem: there are cost protections built into CHIP that are not available with UPP.  As a result, there could be unlimited out of pocket costs to parents of children whose illnesses or injuries are extremely expensive.  With unlimited out or pocket expenses, children would be put at great risk if their families are unable to pay, and, in addition, family finances could be in great jeopardy.

Before the plan goes into effect permanently, it will be extremely important for these issues to be addressed and solved or families will potentially be in a worse situation than they are without these changes.

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Indiana Expands Health Insurance Program for Kids

If you live in Indiana and you have children, there may be some good news coming your way.  The Centers for Medicare and Medicaid Services (CMS) has expanded the Children’s Health Insurance Program.  Under the expansion, if you are a family that earns less than 2 ½ times the poverty level, you can be eligible to enroll your children in the SCHIP. 

The way the income amounts work out translate to families of two earning up to $35,000 annually or a family of four earning up to $53,000 annually.  If your family fits into these financial guidelines and your children need to obtain health insurance, you can apply for the SCHIP program for them. 

There are reasonable premiums for the program.  The premiums range from approximately $22 to $70 monthly, depending on income and the number of children.  Basically the premiums work on a sliding scale.

The expansion of the SCHIP program is a positive step toward making sure that as many children as possible have health insurance benefits.  The eventual goal is to cover all children living in the state.  The state of Indiana and the SCHIP program are actively trying to connect with families who fit the income limits and whose children are not insured.

Most states have some sort of Children’s Health Insurance Plan (CHIP).  These are state-backed programs, usually approved by the federal government through the Centers for Medicare and Medicaid Services (CMS) and facilitated in your local area in conjunction with the county health departments.

For information regarding CHIP benefits in your state, or to see if you qualify, contact your local Social Services or Health Department.  Even if you are not sure you qualify or you think your earnings are too high, don’t hesitate to check into CHIP coverage.  Your circumstance might fit into some of the regulations that would allow you to participate.  It is worth checking into.  Remember, the states are trying to insure as many children as possible so no child will be left without necessary medical care

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