Parent/Adult Coverage
While states have been eager to expand coverage for children, states have not ignored the 37 million uninsured adults in 2006, of which about one-third (11.6 million) were parents with dependent children. 1 To address the greater problem of uninsurance, states have enacted universal coverage, moved towards comprehensive health reform and incrementally expanded and improved public coverage for pregnant women, parents, and other adults.
As of February 7, 2008, three states (Maine, Massachusetts, and Vermont) had enacted comprehensive health reform, and 12 more states were moving towards comprehensive reform by considering proposals or establishing commissions charged with developing recommendations on how to expand coverage; see Kaiser Family Foundation, "States Moving Towards Comprehensive Health Care Reform."
Below are some examples from recent legislative sessions of how states are moving forward on adult coverage. See Eligibility Levels in Medicaid & SCHIP for Children, Pregnant Women, and Parents, as of January 2008 (PDF) for the eligibility levels for all states.
Arizona |
Increased Medicaid income eligibility for pregnant women from 133% to 150% of the federal poverty level (FPL). The expansion was effective October 1, 2007. 2 | |||
Connecticut |
Increased HUSKY A (Medicaid) income eligibility for parents from 150% to 185% of the FPL and for pregnant women from 185% to 250% of the FPL. The parent expansion was effective July 1, 2007 and the pregnant women expansion was effective January 1, 2008. 3 | |||
District of Columbia |
Increased Medicaid income eligibility for pregnant women from 200% to 300% of the FPL. The expansion was effective June 1, 2007. 4 | |||
Indiana |
Increased Medicaid income eligibility level for pregnant women from 150% to 200% of the FPL. The expansion was effective January 1, 2008. 5 | |||
Maryland |
Increased Medicaid income eligibility for adults from 40% to 116% of the FPL. The expansion will be effective July 1, 2008 and parents and caretaker relatives will receive full Medicaid benefits, whereas enrollment for childless adults will be capped and they will receive limited benefits. 6 | |||
Massachusetts |
As part of its comprehensive health reform initiative enacted in April of 2006, Massachusetts expanded its Medicaid program for adults. Those who are still ineligible for Medicaid and lack access to employer-based coverage can buy coverage through the state’s Health Insurance Connector, which offers subsidized private insurance to adults (including parents) with income up to 300% of the FPL. If they remain uninsured, adults face financial penalties unless they can demonstrate that they lack access to an affordable policy. 7 |
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Minnesota |
Increased MinnesotaCare (Medicaid) income eligibility for childless adults from 175% to 215% of the FPL. An expansion up to 200% of the FPL was effective January 1, 2008 and the expansion up to 215% of the FPL will be effective July 1, 2009. 8 | |||
New Jersey |
Reversed earlier enrollment freezes by phasing in FamilyCare (Medicaid) income eligibility expansions for parents from 100% to 133% of the FPL. Parent coverage was expanded from 100% to 115% of the FPL in September 2006 and to 133% of the FPL in September 2007. 9 | |||
Vermont |
When it enacted a comprehensive health reform initiative in May 2006, Vermont established the Catamount Health Plan to offer affordable coverage to uninsured adults, with subsidies for individuals with income up to 300 percent of the FPL. In doing so, it built on its existing Medicaid program, which already offered coverage to parents with income up to 185% of the FPL and childless adults up to 150% FPL. 10 |
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Virginia |
Increased income eligibility for pregnant women in the FAMIS MOMs program from 166% to 185% of the FPL. The expansion was effective July 1, 2007. 11 | |||
Wisconsin |
Increased BadgerCare+ (Medicaid/SCHIP) income eligibility for parents from 185% to 200% of the FPL and for pregnant women from 185% to 300% of the FPL. Both expansions will be effective February 1, 2008. 12 |
Footnotes
1. Kaiser Family Foundation, "Health Insurance Coverage in America: 2006 Data Update," (October 2007). Back
2. H.B. 2789, 48th Legislature (Arizona, 2007). Back
3. S.B. 1484/Public Act 07-185, 2007 Session of the General Assembly (Connecticut, 2007). Back
4. A17-0001/Fiscal Year 2007 Budget Support Act of 2006, 2007 Session of the City Council (District of Columbia, 2007). Back
5. H.B. 1678, 115th General Assembly (Indiana, 2007). Back
6. S.B. 6, 2007 Special Session of the General Assembly (Maryland, 2007). Back
7. C. Barber & M. Miller, "Revisiting Massachusetts Health Reform: 18 Months Later," Community Catalyst (December 2007). Back
8. H.F. 1078, 85th Session of the Legislature (Minnesota, 2007). Back
9. S. 2236/A. 3724, 2004-2005 Session of the Legislature (New Jersey, 2005). Back
10. Health Care Reform of 2006 page at http://hcr.vermont.gov/ and Kaiser Family Foundation, "Vermont Health Care Reform Plan," (December 2007). Back
11. Virginia House Appropriations Committee and Senate Finance Committee, "Summary of 2006-2008 Budget Actions," (April 20, 2007). Back
12. S.B. 40/Act 20, October 2007 Special Session of the Legislature (Wisconsin, 2007). Back