Phew! On May 8, we saw the end to another state legislative session—with great results and plenty of new work moving forward.
Over the course of this week, I’m going to write about each of the three bills we actively supported this year, including the Medicaid expansion (SB 200), dental benefits for adults on Medicaid (SB 242), and removing the three-month waiting period in CHP+ (SB 8). If you’re reading this early in the week, check back again later to read the rest!
And if you’re interested in our complete thoughts on the 2012 legislative session, our brand new Moving Public Policy Forward document will be released at our Annual Meeting on Monday, May 20—don’t miss it!
SB 200 - Medicaid Expansion
“It’s not our fault that our bodies went wrong.” –Gail Marmo, 62, of Aurora
Last summer, a mother and son let us into their tumultuous lives. They both suffer from complex medical conditions and struggle to meet their health care needs, piecing together every possible resource.
Nineteen-year-old Robert graduated from high school and looked forward to completing his community college courses and working as an auto mechanic to support himself and his mother. However, he was hindered from pursuing those dreams by debilitating headaches from a pseudo-tumor near his brain, constant pain from early arthritis, and a misaligned spine.
Until his last birthday, he received regular medical care through his Child Health Plan Plus (CHP+) coverage. Now though, as an adult, and unable to get a disability waiver, his only option for coverage was to apply for Medicaid through the limited eligibility for adults without dependent children (with a current cap of 13,000). He landed on the waiting list and has had to make tough choices of which treatments to continue paying for out-of-pocket. His inability to hold a steady job due to his medical conditions and his mother’s own medical challenges have led to an especially difficult life.
Colorado is close to giving some respite to this family, and 160,000 others around the state. Senate Bill 13-200 becomes law today, which allows Colorado to make Medicaid available for those who qualify starting on January 1, 2014. Research shows this expansion will make a difference in reducing suffering and early death as well as economically benefit Colorado as a whole.
This law makes the most sense to close some of the gaps in our current safety net and offer Coloradans like Robert Marmo the ability to address medical needs so they can live their lives as productive citizens. It was passed with significant efforts from the state and many of our partner organizations.
SB 242 - Dental benefits for adults covered by Medicaid
“You have to learn to live with the pain or learn to live without a tooth.” –resident of an affordable housing complex
Research shows that untreated dental issues lead to abscesses, infections, and pain that affect the rest of the body. It also exacerbates existing chronic conditions, such as diabetes or stroke. Women who are pregnant and have untreated oral disease are at risk of delivering low-birth weight or premature babies. The pain also affects our ability to work—nationally, 164 million work hours are lost each year due to dental issues.
Adults covered by Medicaid do not have many options to receive dental care services. The current Medicaid benefit package does not include a preventive or maintenance benefit, so unless someone in need can access care at a safety-net or low-cost dental provider, the only treatment option is extraction in the emergency room if the pain gets too bad or if the tooth is too rotten. Out-of-pocket, regular cleanings can cost anywhere from $100-400 without insurance, and it is nearly impossible to follow the guideline of twice-yearly cleanings when your income is below the poverty level. However, by offering preventive care as a part of Medicaid, we can save 10 times as much as we would pay for delayed treatment in emergency rooms.
CCMU recently partnered with Mercy Housing, an affordable housing provider for low-income adults and families, to talk to residents about their health. Many issues rose to the top, but the inability to find affordable access to a dentist was a recurring sentiment.
We worked this legislative session with the Department of Health Care Policy and Financing and many other groups to support the passage of this bill, and in the middle of next year, Medicaid will begin offering dental benefits to adults. We are pleased to see Colorado enact this law as we strongly believe that good oral health is a fundamental part of overall physical health, as well as economic opportunity.
SB 8 - Removing the CHP+ Waiting Period
“Families are forced to make difficult decisions between health care and other necessities such as housing and food.” –All Kids Covered coalition member
Child Health Plan Plus (CHP+) is low-cost, public health insurance for low- and middle-income children and pregnant women who earn too much to qualify for Medicaid, but cannot afford or access private health insurance. Until April of this year, if a child had insurance through a parent’s employer, which paid more than 50% of the dependent premium, that child had to be uninsured for 90 days before they were eligible to get health insurance coverage through CHP+, even if they qualified otherwise.
SB11-008 removed the requirement for this waiting period. This policy change removes red tape for families and workers who support families to obtain coverage through CHP+. The change also ensures that kids don’t have to go without health insurance for three months, potentially missing out on important preventive care that helps them manage a chronic condition like asthma.
Our work on this issue was prompted by families from different parts of the state who contacted us about their frustrations with this policy. The employer-sponsored coverage available to them for their children was getting increasingly hard to maintain with rising health care costs. CHP+ was an option only if they would drop their kids from their private coverage. Three months is a long time for active kids who are exposed to germs at school and play hard on the playground.
By strengthening health coverage for children in recent years, Colorado leaders have done the right thing for families and the smart thing for taxpayers. Adopting the common sense policy to remove the three month waiting period for enrollment in CHP+ is one more step in the right direction.
Many beneficial bills passed this legislative session that made the health care system more inclusive and affordable. Now, the focus turns to implementing these new laws to reap the benefits, and continuing to identify and resolve gaps either through community work or additional policy change. Even though we fully acknowledge that our work is not yet complete, we are pleased with the advances made this legislative session to improve care for the medically underserved.