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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 7 care while in an uninsured status. Preventive and delayed care due to lack of coverage leads to higher treatment costs. The American Hospital Association Health Statistics & the Employee Benefits Research Institute (EBRI) analysis of March 1995 Current Population Survey of Nebraska estimated that of 463,683 children in Nebraska, 45,689 were covered by Medicaid and 43,397 have no health insurance. It should be noted, however, that the figure of 45,689 covered by Medicaid is low; in March 1995, Nebraska Medicaid had 79,834 children eligible in the children's categories (this does not include children who were eligible through programs for persons with disabilities).

2.2. Describe the current state efforts to provide or obtain creditable health coverage for uncovered children by addressing: (Section 2102)(a)(2) (42CFR 457.80(b))

2.2.1. The steps the state is currently taking to identify and enroll all uncovered children who are eligible to participate in public health insurance programs (i.e., Medicaid and state-only child health insurance):

The Nebraska Comprehensive Health Insurance Pool (CHIP) program is a state-only insurance program that was created in 1985. Children who qualify for Medicaid are not eligible for Nebraska’s CHIP program since persons must be “uninsurable” and CHIP losses are covered by a reduction in state insurance premiums taxes owed by companies who participate in the pool. Individuals in the CHIP pay premiums that are currently 125 percent of the average of the five highest volume plans in the state, and premiums have been as high as 150 percent of the average premium - the Insurance Commissioner sets the rate. Less than 300 children are enrolled in CHIP. HHSS staff has estimated that these children are in families with incomes that exceed the 200 percent threshold so it is unlikely that there will be any substitution with Kids Connection.

In addition to Medicaid, there are other programs and service delivery systems that (1) provide selected services and/or (2) work toward linking families with health services whether it be Medicaid coverage or other community resources. To promote and provide children and youth with comprehensive services and a full continuum of care through Medicaid, the following direct and indirect outreach efforts are utilized:

• Employee newsletters are used to relay updates, changes, and information about initiatives to HHSS employees statewide. Internal electronic mail is used as a vehicle to notify all central and field staff of changes and updates on eligibility and services.