Governor Ted Kulongoski Governor's Healthy Kids Plan

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Governor Ted Kulongoski

Offices

Governor's Healthy Kids Plan

The Problem:

More than 117,000 Oregon children live without health insurance. They lack access to doctors, medicine, eyeglasses, asthma inhalers, and the other health care services people with insurance take for granted. Nearly half these children may be eligible for coverage under one of Oregon’s existing public programs, but they are not enrolled. Thousands more are from working families who earn too much to qualify for those programs, but not enough to pay for private insurance.

When children lack health care, everyone suffers. Kids without access to heath care don’t do as well in school. Their treatable illnesses and injuries go untreated making them more likely to end up in emergency rooms, where they receive extremely expensive care. They become sick more often and miss more school days, requiring their parents have to stay home and care for them – which also translates to lower productivity for employers.

The Solution:

Enact Governor Kulongoski’s Healthy Kids Plan. Provide every child in Oregon access to the health care he or she needs to grow into a happy, productive adult.

Meet children's health care needs in three ways

Continue expanding school-based health centers.
Improve and expand access to the state’s Medicaid and SCHIP programs.
Expand health care coverage for kids by giving parents with higher incomes (too high to qualify for federal programs) the opportunity to buy affordable, state-subsidized group coverage for their children.

Key components

All uninsured Oregon children up to age 19 are eligible for coverage.
Every child insured through the Plan will have the same insurance card.
Streamline the Plan and simplify the enrollment process by using existing programs and partnerships with schools, health care providers and NGOs.
All kids in families with incomes up to 200 percent of the federal poverty level (for a family of four - $37,700.00) will be eligible for comprehensive coverage through the existing Oregon Health Plan and Family Health Insurance Assistance Program (FHIAP) benefit models.
Families with incomes above 200 percent of the federal poverty level will be eligible to buy affordable comprehensive group coverage for their children, including mental health and dental benefits; a sliding scale based on family income will determine the size of premiums and co-pays.
School-based health centers will expand into five new counties; and at least five more centers will open in the 19 counties that already offer school-based health care.

The Process
Governor Kulongoski has asked the Medicaid Advisory Committee (MAC) to work with state agencies and community partners to design some of the key elements of the Healthy Kids Plan. In the next three months, MAC will focus on recommendations around the delivery system serving kids in Oregon, enrollment and retention in the Plan, and the benefit options for expanding coverage for children in families with incomes above 200 percent of the federal poverty level, including the appropriate levels of state-subsidy and family cost-sharing. In creating benefit options for working, middle class families, MAC will explore the possibility of parents purchasing group coverage through OHP Managed Care, PEBB and FHIAP. In April 2006, MAC will host public hearings statewide on their recommendations to the Governor.

Previous efforts to expand health care access to kids

In 2003, Governor Kulongoski preserved funding for School-Based Health Centers and in 2005 the Governor expanded state funding for SBHC, growing the number of counties with SBHCs from 14 to 19. Oregon will finish the current biennium with at least 47 certified SBHCs.
In 2004 Governor Kulongoski changed the asset limit for Oregon’s State Children’s Health Insurance Program (SCHIP) from $5000 to $10,000. He also directed the Department of Human Services to sponsor two pilot projects for enhanced outreach to children who are eligible for, but not enrolled, in the Oregon Health Plan and SCHIP. Lessons learned from that outreach effort will be applied to the Healthy Kids Plan enrollment and retention policies.
To improve access to private health insurance coverage for more children in 2004 Governor Kulongoski developed a Children’s Group Insurance Plan in conjunction with the Insurance Pool Governing Board. The Children’s Group Plan offers an opportunity for employers to, at a minimum, provide coverage to the children of their employees. The plan became available in early 2005. Only a small number of small employers have enrolled in the plan, highlighting the need for more affordable group coverage options for kids, as will be part of the Healthy Kids Plan.

Affordable Health Care for Every Child

Governor's_Press_Release
Governor's_Remarks
Read_the_Summary_Document
Frequently_Asked_Questions
Review the Chart (pdf)

More Information

Healthy_Kids_Plan_(pdf)
Healthy_Kids_Presentation (ppt)

Page updated: November 16, 2006

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