PROGRAM EXTENDS HEALTH CARE COVERAGE; IDENTIFYING ELIGIBLE CHILDREN PROVES TASK

After three months of enrollment, 22,396 of the 90,000 eligible low-income families in Missouri had been enrolled in a medical insurance plan known as the Children's Health Initiative Program.

Identifying and finding the 90,000 children who became eligible for health-care coverage has proved a formidable task for the state's social services agency despite widespread publicity about available benefits and a toll-free number.

The Missouri Department of Social Services estimates there are 63,000 children in families with poverty levels from 101 percent to 185 percent eligible for CHIP, with an additional 27,000 qualifying in families with levels from 186 percent to 300 percent of poverty.

Missouri's designation for the new Medicaid assistance initiative is Managed Care Plus. Administered at the state level by the Department of Social Services, the program calls for the inclusion of children from poverty-level and low-income families who don't have subsidized health-care insurance or who were previously judged ineligible for Medicaid assistance because of income guidelines.

Missouri is one of five states to extend eligibility for the health plan to children in families with incomes as high as 300 percent more than the poverty level. And the state is one of four to extend coverage to age 19. Missouri became the first in the nation to receive a Medicaid waiver to expand Medicaid coverage in concert with its CHIP plan.

Only Tennessee includes children in families with incomes 400 percent higher than the poverty level, with the age 19 cutoff.

Proposed as a new health-care initiative by Gov. Mel Carnahan in last January's State of the State address, legislators approved $151.9 million for the program's first year, with the bulk of funding provided by the federally financed Medicaid program. The total planned expenditure for the fiscal year that began July 1 calls for an outlay of $11.4 million from the state's general revenue fund.

Marilynn Knipp, associate director of the Social Services department, said the state began accepting applications for CHIP benefits in July, with Managed Care Plus coverage beginning in September.

Although all of Missouri's children through age 18 in families with income at 100 percent poverty level are covered, children ages 6 through 18 in families at the 101 percent to 133 percent level had no health insurance prior to the CHIP plan. Additionally, children ages 1 through 18 in families at the 134 percent to 300 percent poverty level weren't covered.

Family funding participation up to $65 a month regardless of the number of children is required for those in the 226 percent to 300 percent level.

Knipp said the typical target family for CHIP coverage is a two-parent, two-child family with an annual income of $22,000 and with the wage-earners working for companies with less than 20 employees.