TN opens health plan for adults to sickest children

Move comes after CoverKids program for needy froze enrollment By Christina E. Sanchez • THE TENNESSEAN • December 4, 2009 Amid controversy about the state's decision to cut off enrollment for a health insurance plan for low-income children, Tennessee expanded another program Thursday to give the sickest children an alternative. AccessTN, a state-subsidized insurance plan, previously was reserved for adults who were uninsurable because of pre-existing conditions. The adults must pay a monthly premium for the insurance, although financial assistance is available. The AccessTN board voted Thursday to allow medically uninsurable children to apply as a stopgap measure to the frozen enrollment of CoverKids. Officials do not know when CoverKids will reopen. On Wednesday, The Tennessean reported that financial constraints forced the state to shut down new enrollment for CoverKids and a cousin program for adults, CoverTN, prompting an outcry from health policy advocates. Existing enrollees kept their insurance. "We realize this isn't a solution for everyone, but it's an honest effort," said Joe Burchfield, spokesman for Cover Tennessee, the state program that includes CoverKids, CoverTN and AccessTN. "We're trying to manage within our means. This is about the only action we can take right now." Burchfield said it isn't known how many children qualify for AccessTN or how many the program can accept. To qualify, a child must be medically uninsurable and have had no health insurance for three months. "It would be pretty difficult to isolate the number of children that would qualify for this," he said. Premiums range from $284 to $410 per month. Financial aid for up to 60 percent of the premium could be available for families earning less than $75,000 annually. The program just cleared a waiting list for that aid, and more assistance could still be given. Critics say it isn't enough Advocates say the expansion of AccessTN isn't enough and that the move falls short during a time when unemployment is high, family budgets are tight and the demand for health insurance is rising. "This fixes it only for a tiny percentage of families — for kids who are too sick and uninsurable," said Michele Johnson, who works on kids' health issues for the Tennessee Justice Center. "By and large, the reason why other states have not frozen their programs is that most kids don't fit into those categories." Money is tight for the state as it faces a $1.5 billion shortfall in a $29 billion budget. Many departments have been asked to cut or save where they can. CoverKids won't have its $115 million budget cut, but the program is expected to serve only the number of children it can afford, which includes about 44,000 children. The CoverKids program — which serves families not poor enough to qualify for TennCare, the state's Medicaid program — will not reopen until more money is found or until people leave the program through natural attrition. About 350 of the children on CoverKids bought in, or paid a premium to get the coverage. Johnson said AccessTN would be unaffordable for many families. "AccessTN premiums are beyond the means of families who already find their backs to the wall financially," she said. About 147,000 children in Tennessee lack health insurance, according to the Kaiser Family Foundation, a non-profit health policy organization. Burchfield said no additional funding will be given to AccessTN, which serves about 3,800 adults, to expand to children. "The budget for the program now is $23 million," he said. "There is room in the budget to allow this to happen." Amid controversy about the state's decision to cut off enrollment for a health insurance plan for low-income children, Tennessee expanded another program Thursday to give the sickest children an alternative. AccessTN, a state-subsidized insurance plan, previously was reserved for adults who were uninsurable because of pre-existing conditions. The adults must pay a monthly premium for the insurance, although financial assistance is available. The AccessTN board voted Thursday to allow medically uninsurable children to apply as a stopgap measure to the frozen enrollment of CoverKids. Officials do not know when CoverKids will reopen. On Wednesday, The Tennessean reported that financial constraints forced the state to shut down new enrollment for CoverKids and a cousin program for adults, CoverTN, prompting an outcry from health policy advocates. Existing enrollees kept their insurance. "We realize this isn't a solution for everyone, but it's an honest effort," said Joe Burchfield, spokesman for Cover Tennessee, the state program that includes CoverKids, CoverTN and AccessTN. "We're trying to manage within our means. This is about the only action we can take right now." Burchfield said it isn't known how many children qualify for AccessTN or how many the program can accept. To qualify, a child must be medically uninsurable and have had no health insurance for three months. "It would be pretty difficult to isolate the number of children that would qualify for this," he said. Premiums range from $284 to $410 per month. Financial aid for up to 60 percent of the premium could be available for families earning less than $75,000 annually. The program just cleared a waiting list for that aid, and more assistance could still be given. Critics say it isn't enoughAdvocates say the expansion of AccessTN isn't enough and that the move falls short during a time when unemployment is high, family budgets are tight and the demand for health insurance is rising. "This fixes it only for a tiny percentage of families — for kids who are too sick and uninsurable," said Michele Johnson, who works on kids' health issues for the Tennessee Justice Center. "By and large, the reason why other states have not frozen their programs is that most kids don't fit into those categories." Money is tight for the state as it faces a $1.5 billion shortfall in a $29 billion budget. Many departments have been asked to cut or save where they can. CoverKids won't have its $115 million budget cut, but the program is expected to serve only the number of children it can afford, which includes about 44,000 children. The CoverKids program — which serves families not poor enough to qualify for TennCare, the state's Medicaid program — will not reopen until more money is found or until people leave the program through natural attrition. About 350 of the children on CoverKids bought in, or paid a premium to get the coverage. Johnson said AccessTN would be unaffordable for many families. "AccessTN premiums are beyond the means of families who already find their backs to the wall financially," she said. About 147,000 children in Tennessee lack health insurance, according to the Kaiser Family Foundation, a non-profit health policy organization. Burchfield said no additional funding will be given to AccessTN, which serves about 3,800 adults, to expand to children. "The budget for the program now is $23 million," he said. "There is room in the budget to allow this to happen."