Washington:

Coverage to All Children

Program Elements

Washington creates new coverage opportunities for all children. Children with family incomes up to 250 percent of the federal poverty level (FPL) are eligible regardless of immigration status. In January 2009, the state expects to raise eligibility to 300 percent of the FPL and allow families with incomes above 300 percent of the FPL to buy-in at the full cost of coverage beginning in January 2009.

The legislation also stipulates that every child in the state with a family income up to 250 percent of the FPL is entitled to health coverage and thus the provision of such is not subject to "whether the money is available" in a tight budget environment.

Other provisions of the program are:

• Addresses barriers to coverage. The initiative creates one seamless health care program for children with the same application and renewal processes and coordination among the different programs by income level. For example, since eligibility for the state's current SCHIP program requires that a child be uninsured for four months prior to enrollment, the same waiting period will apply for all SCHIP children (those with family income between 200 and 300 percent of the FPL) and for immigrant children in the state program at the SCHIP income level. Additionally, the state is directed to develop an improved online application and a plan to increase retention in the program.

• Improves access to quality care in a medical home. The legislation outlines the importance of a medical home in improving the quality of care children receive. It requires that the state work with stakeholders to develop quality measures to evaluate medical homes. These quality measures will then be linked to increased reimbursement for pediatric providers.

• Invests in outreach to find and enroll eligible children. The legislation directs the state to undertake a targeted outreach plan to enroll children in health coverage and assist parents with understanding health coverage and benefits. It requires that the state contract with community-based organizations and local government entities, collaborate with other state and local agencies, and use existing systems such as school meals to identify eligible children. In addition, it uses assistors, paid $75 per successful application, to help families with completing applications. $4.4 million was appropriated in the fiscal year 07-09 budget for these outreach activities.