Losing Out: State-by-State Data, 12/22/03

December 22, 2003

LOSING OUT:
States Are Cutting 1.2 to 1.6 Million Low-Income People from Medicaid,
SCHIP and Other State Health Insurance Programs
by Leighton Ku and Sashi Nimalendran

State-by-State Data
Full Report: PDF, HTML | Press Release: PDF, HTML
State by State Data: Map of States, PDF, HTML

States That Cut Enrollment in Medicaid, SCHIP or Other State Health Insurance Programs:
Summary of State Policies and Impacts

State

Estimate of Number Affected

Brief Description of Cuts

United States

1.2 million to 1.6 million (490,000 to 650,000 children)

Cuts adopted in 34 states in state fiscal years 2003 and 2004. Almost half of the cuts are for children, but there also are cuts for low-income parents, senior citizens, people with disabilities, childless adults, and immigrants.

Alabama

3,000 to 4,000

Stopped admitting eligible low-income children in SCHIP

Alaska

1,600

Reduced income limit for children in SCHIP from 200 percent of the poverty line ($38,000 for a family of three in Alaska) to 175 percent ($33,000). Eliminated inflation adjustments on income limits for children in SCHIP and for pregnant women and aged and disabled people in Medicaid, so that income limits effectively fall over time.

Arizona

no estimate

Created enrollment barriers by requiring children, adults and certain aged and disabled people to submit paperwork every 6 months, rather than permitting 12-month continuous eligibility.

Arkansas

no estimate

Increased monthly premium for certain disabled children who need medical care at home.

California

250,000 to 500,000

Created barriers that make it harder for low-income parents to stay enrolled in Medicaid. (In addition, Gov. Schwarzenegger has just proposed to stop enrolling eligible low-income children in SCHIP and to stop admitting immigrants in other health coverage programs, affecting an additional 114,000 children and 78,000 immigrants. These proposals are not included in the estimates of cuts already enacted in California.)

Colorado

16,300

Stopped admitting eligible low-income children and pregnant women in SCHIP. (Also passed legislation to end Medicaid coverage for 3,500 legal immigrants. This is currently subject to an injunction because of a legal challenge and is not counted in our estimate.)

Connecticut

20,500

Reduced Medicaid income eligibility limit for low-parents from 150 percent to 100 percent of the poverty line (from ($22,890 to $15,260 for a family of three). Because of an injunction, this is delayed since many of these parents will retain transitional Medicaid benefits, but they will lose coverage when their transitional benefits expire. Created enrollment barriers for children that make it harder to apply for Medicaid from clinics and that make it harder to remain enrolled. Stopped admitting recent legal immigrants to Medicaid.

Florida

74,000

Stopped admitting low-income eligible children in SCHIP and now place them on a waiting list. About 44,000 have been placed on this list since July 2003. This adds to a waiting list of about 27,000 that already existed for immigrant and other children. Cut income eligibility limits for seniors and people with disabilities from 90 percent of the poverty line to 88 percent (from $8,082 for a single senior to $7,902)

Indiana

32,000 to 40,000

Created enrollment barriers by requiring Medicaid children to submit paperwork every 6 months, rather than permitting 12-months coverage. Reduced Medicaid income limits for seniors and people with disabilities by narrowing methods of computing disposable income (currently blocked by lawsuit, so this cut is not counted).

Iowa

no estimate

Increased premiums for working disabled people's Medicaid coverage.

Kansas

no estimate

Tightened requirements so that fewer people who have left welfare for work retain their Medicaid coverage.

Kentucky

3,000

Increased monthly premiums for children in SCHIP. Terminated Medicaid coverage of parents who do not meet work requirements in welfare program. Reduced amount that an institutionalized person's spouse can keep.

Louisiana

no estimate

Reduced Medicaid income limit for seniors and people with disabilities by narrowing methods of counting disposable income.

Maryland

5,000

Stopped admitting eligible children in SCHIP who have incomes between 200 percent and 300 percent of the poverty line (between $30,520 and $45,060 for a family of three). Imposed monthly premiums for children with incomes between 185 percent of the poverty line and 200 percent ($28,230 to $30,520 for a family of three) in SCHIP, reducing enrollment of children in that income range by about half.

Massachusetts

13,900

Temporarily ended insurance coverage for certain long-term unemployed people. Eliminated health insurance eligibility for certain immigrants. Increased premiums for some low-income children in Medicaid. Reduced Medicaid eligibility for certain adults by adding an asset limit.

Minnesota

35,000

Cut eligibility and benefits for certain low-income adults who do not have children. Reduced Medicaid eligibility for newborn babies whose mothers were on Medicaid from 24 months to 12 months. Other miscellaneous cuts.

Missouri

32,000

Lowered Medicaid income eligibility limit for parents from 100 percent of the poverty line to 77 percent (from $15,260 for a family of three to $11,750). This is somewhat delayed because of a court injunction, but the parents will lose Medicaid coverage when their transitional Medicaid benefits expire.

Montana

no estimate

Stopped admitting eligible low-income children in SCHIP and place them on a waiting list.

Nebraska

28,700

Cut income eligibility limits for children and parents by changing methods of counting income and household composition. This is delayed by a court injunction, but the people will lose coverage when their transitional Medicaid benefits expire. Created enrollment barriers by making it more difficult for children to apply for Medicaid from health clinics. Ended Medicaid coverage for poor 19 and 20 year olds.

Nevada

2,900

Cut Medicaid income limits for unemployed workers by changing methods of accounting for unemployment benefits.

New Jersey

1,900

Stopped admitting new low-income parents applying for NJ Family Care. Terminated coverage for certain immigrants and adults.

North Carolina

no estimate

Reduced Medicaid eligibility limits for certain seniors and people with disabilities by changing methods computing assets in determining eligibility. Reduced Medicaid coverage for low-income parents who left welfare for work from two years to one.

North Dakota

2,600

Reduced Medicaid eligibility for two-parent families with a parent who works more than 100 hours per month . Narrowed eligibility for certain seniors.

Oklahoma

8,300

Ended Medicaid coverage for low-income parents, children and seniors whose disposable incomes are reduced because of higher medical expenses.

Oregon

40,000

Increased monthly premiums for low-income people in the Oregon Health Plan (standard). Also restricted other eligibility criteria. Ended Medicaid coverage for those whose disposable incomes are reduced because of high medical expenses. Cancelled earlier plans to expand coverage for adults with incomes over the poverty line.

Rhode Island

1,200

Increased monthly premiums for families (including children) in Rite Care.

South Carolina

7,000

Reduced Medicaid income limit for parents by adding a limit on gross income. Created enrollment barrier by increasing paperwork requirements to renew children's Medicaid coverage.

Tennessee

150,000

Broad reductions in eligibility for TennCare. About 200,000 lost coverage in mid-2003 when the state required that large numbers of beneficiaries reapply. While the state has permitted a grace period for those who lost coverage to reapply, only a limited number are expected to successfully re-enroll. Reduced eligibility for "uninsurable" people with chronic health problems who cannot get private health insurance. Stopped admitting a large number of eligible of low-income children into TennCare.

Texas

345,000 to 495,000

Imposed an asset test for children in SCHIP, added monthly premiums and made it harder for children to stay enrolled in SCHIP. This will reduce enrollment in SCHIP by about one-third. Those who gain SCHIP coverage will not be able to use medical care in the first three months. Created enrollment barriers for children in Medicaid by rescinding a plan to streamline eligibility by letting the children stay enrolled for 12 months. Cut Medicaid income eligibility limit for pregnant women from 175 percent of the poverty line to 158 percent (from $21,210 for family of two to $19,150). Eliminated Medicaid eligibility of low-income adults whose disposable income is reduced because they have high medical expenses. Terminated Medicaid coverage for parents who are unable to meet work requirements for welfare.

Utah

no estimate

Stopped admitting eligible, low-income children in SCHIP.

Vermont

10,000

Increased monthly premiums for certain low-income adults, children and seniors in health coverage programs.

Virginia

no estimate

Reduced eligibility that lets low-income adults retain Medicaid when they leave welfare for work. Eliminated inflation adjustments in Medicaid income limits for certain seniors and people with disabilities.

Washington

116,000

Ended Medicaid eligibility for recent legal immigrants. Increased enrollment barriers for children and parents that make it more difficult for them to stay enrolled in Medicaid. Plan to increase premiums for low-income children in Medicaid. Reduced enrollment cap for Basic Health program by 36,000.

Wisconsin

1,600

Created enrollment barriers for working families applying for BadgerCare by requiring further paperwork to verify income. Increased premiums for families with incomes greater than 150 percent of the poverty line. Reduced eligibility for seniors by modifying methods of counting assets and changing rules related to amounts that spouses may retain.

Full Report: PDF, HTML | Press Release: PDF, HTML
State by State Data: Map of States, PDF, HTML

LOSING OUT: States Are Cutting 1.2 to 1.6 Million Low-Income People from Medicaid, SCHIP and Other State Health Insurance Programs by Leighton Ku and Sashi Nimalendran
State-by-State Data Full Report: PDF, HTML \| Press Release: PDF, HTML State by State Data: Map of States, PDF, HTML

States That Cut Enrollment in Medicaid, SCHIP or Other State Health Insurance Programs: Summary of State Policies and Impacts
State	Estimate of Number Affected	Brief Description of Cuts
United States	1.2 million to 1.6 million (490,000 to 650,000 children)	Cuts adopted in 34 states in state fiscal years 2003 and 2004. Almost half of the cuts are for children, but there also are cuts for low-income parents, senior citizens, people with disabilities, childless adults, and immigrants.
Alabama	3,000 to 4,000	Stopped admitting eligible low-income children in SCHIP
Alaska	1,600	Reduced income limit for children in SCHIP from 200 percent of the poverty line ($38,000 for a family of three in Alaska) to 175 percent ($33,000). Eliminated inflation adjustments on income limits for children in SCHIP and for pregnant women and aged and disabled people in Medicaid, so that income limits effectively fall over time.
Arizona	no estimate	Created enrollment barriers by requiring children, adults and certain aged and disabled people to submit paperwork every 6 months, rather than permitting 12-month continuous eligibility.
Arkansas	no estimate	Increased monthly premium for certain disabled children who need medical care at home.
California	250,000 to 500,000	Created barriers that make it harder for low-income parents to stay enrolled in Medicaid. (In addition, Gov. Schwarzenegger has just proposed to stop enrolling eligible low-income children in SCHIP and to stop admitting immigrants in other health coverage programs, affecting an additional 114,000 children and 78,000 immigrants. These proposals are not included in the estimates of cuts already enacted in California.)
Colorado	16,300	Stopped admitting eligible low-income children and pregnant women in SCHIP. (Also passed legislation to end Medicaid coverage for 3,500 legal immigrants. This is currently subject to an injunction because of a legal challenge and is not counted in our estimate.)
Connecticut	20,500	Reduced Medicaid income eligibility limit for low-parents from 150 percent to 100 percent of the poverty line (from ($22,890 to $15,260 for a family of three). Because of an injunction, this is delayed since many of these parents will retain transitional Medicaid benefits, but they will lose coverage when their transitional benefits expire. Created enrollment barriers for children that make it harder to apply for Medicaid from clinics and that make it harder to remain enrolled. Stopped admitting recent legal immigrants to Medicaid.
Florida	74,000	Stopped admitting low-income eligible children in SCHIP and now place them on a waiting list. About 44,000 have been placed on this list since July 2003. This adds to a waiting list of about 27,000 that already existed for immigrant and other children. Cut income eligibility limits for seniors and people with disabilities from 90 percent of the poverty line to 88 percent (from $8,082 for a single senior to $7,902)
Indiana	32,000 to 40,000	Created enrollment barriers by requiring Medicaid children to submit paperwork every 6 months, rather than permitting 12-months coverage. Reduced Medicaid income limits for seniors and people with disabilities by narrowing methods of computing disposable income (currently blocked by lawsuit, so this cut is not counted).
Iowa	no estimate	Increased premiums for working disabled people's Medicaid coverage.
Kansas	no estimate	Tightened requirements so that fewer people who have left welfare for work retain their Medicaid coverage.
Kentucky	3,000	Increased monthly premiums for children in SCHIP. Terminated Medicaid coverage of parents who do not meet work requirements in welfare program. Reduced amount that an institutionalized person's spouse can keep.
Louisiana	no estimate	Reduced Medicaid income limit for seniors and people with disabilities by narrowing methods of counting disposable income.
Maryland	5,000	Stopped admitting eligible children in SCHIP who have incomes between 200 percent and 300 percent of the poverty line (between $30,520 and $45,060 for a family of three). Imposed monthly premiums for children with incomes between 185 percent of the poverty line and 200 percent ($28,230 to $30,520 for a family of three) in SCHIP, reducing enrollment of children in that income range by about half.
Massachusetts	13,900	Temporarily ended insurance coverage for certain long-term unemployed people. Eliminated health insurance eligibility for certain immigrants. Increased premiums for some low-income children in Medicaid. Reduced Medicaid eligibility for certain adults by adding an asset limit.
Minnesota	35,000	Cut eligibility and benefits for certain low-income adults who do not have children. Reduced Medicaid eligibility for newborn babies whose mothers were on Medicaid from 24 months to 12 months. Other miscellaneous cuts.
Missouri	32,000	Lowered Medicaid income eligibility limit for parents from 100 percent of the poverty line to 77 percent (from $15,260 for a family of three to $11,750). This is somewhat delayed because of a court injunction, but the parents will lose Medicaid coverage when their transitional Medicaid benefits expire.
Montana	no estimate	Stopped admitting eligible low-income children in SCHIP and place them on a waiting list.
Nebraska	28,700	Cut income eligibility limits for children and parents by changing methods of counting income and household composition. This is delayed by a court injunction, but the people will lose coverage when their transitional Medicaid benefits expire. Created enrollment barriers by making it more difficult for children to apply for Medicaid from health clinics. Ended Medicaid coverage for poor 19 and 20 year olds.
Nevada	2,900	Cut Medicaid income limits for unemployed workers by changing methods of accounting for unemployment benefits.
New Jersey	1,900	Stopped admitting new low-income parents applying for NJ Family Care. Terminated coverage for certain immigrants and adults.
North Carolina	no estimate	Reduced Medicaid eligibility limits for certain seniors and people with disabilities by changing methods computing assets in determining eligibility. Reduced Medicaid coverage for low-income parents who left welfare for work from two years to one.
North Dakota	2,600	Reduced Medicaid eligibility for two-parent families with a parent who works more than 100 hours per month . Narrowed eligibility for certain seniors.
Oklahoma	8,300	Ended Medicaid coverage for low-income parents, children and seniors whose disposable incomes are reduced because of higher medical expenses.
Oregon	40,000	Increased monthly premiums for low-income people in the Oregon Health Plan (standard). Also restricted other eligibility criteria. Ended Medicaid coverage for those whose disposable incomes are reduced because of high medical expenses. Cancelled earlier plans to expand coverage for adults with incomes over the poverty line.
Rhode Island	1,200	Increased monthly premiums for families (including children) in Rite Care.
South Carolina	7,000	Reduced Medicaid income limit for parents by adding a limit on gross income. Created enrollment barrier by increasing paperwork requirements to renew children's Medicaid coverage.
Tennessee	150,000	Broad reductions in eligibility for TennCare. About 200,000 lost coverage in mid-2003 when the state required that large numbers of beneficiaries reapply. While the state has permitted a grace period for those who lost coverage to reapply, only a limited number are expected to successfully re-enroll. Reduced eligibility for "uninsurable" people with chronic health problems who cannot get private health insurance. Stopped admitting a large number of eligible of low-income children into TennCare.
Texas	345,000 to 495,000	Imposed an asset test for children in SCHIP, added monthly premiums and made it harder for children to stay enrolled in SCHIP. This will reduce enrollment in SCHIP by about one-third. Those who gain SCHIP coverage will not be able to use medical care in the first three months. Created enrollment barriers for children in Medicaid by rescinding a plan to streamline eligibility by letting the children stay enrolled for 12 months. Cut Medicaid income eligibility limit for pregnant women from 175 percent of the poverty line to 158 percent (from $21,210 for family of two to $19,150). Eliminated Medicaid eligibility of low-income adults whose disposable income is reduced because they have high medical expenses. Terminated Medicaid coverage for parents who are unable to meet work requirements for welfare.
Utah	no estimate	Stopped admitting eligible, low-income children in SCHIP.
Vermont	10,000	Increased monthly premiums for certain low-income adults, children and seniors in health coverage programs.
Virginia	no estimate	Reduced eligibility that lets low-income adults retain Medicaid when they leave welfare for work. Eliminated inflation adjustments in Medicaid income limits for certain seniors and people with disabilities.
Washington	116,000	Ended Medicaid eligibility for recent legal immigrants. Increased enrollment barriers for children and parents that make it more difficult for them to stay enrolled in Medicaid. Plan to increase premiums for low-income children in Medicaid. Reduced enrollment cap for Basic Health program by 36,000.
Wisconsin	1,600	Created enrollment barriers for working families applying for BadgerCare by requiring further paperwork to verify income. Increased premiums for families with incomes greater than 150 percent of the poverty line. Reduced eligibility for seniors by modifying methods of counting assets and changing rules related to amounts that spouses may retain.