State Officials Decry Federal Policy On Children's Health Insurance

WASHINGTON — State health officials are decrying new federal guidelines that require many children to be uninsured for a full year before they have access to government-subsidized coverage.

Waiting periods prevent families from dropping private insurance to get cheaper or better coverage for their children through the State Children's Health Insurance Program, or SCHIP.

But the vast majority of states require much shorter waits — typically one month to six months — than the Bush administration will require. Only Alaska has a one-year wait; in 16 states, there is no waiting period.

State officials say the policy could prevent pregnant women from having health coverage during any portion of their pregnancy or it could keep children from obtaining insurance even if a parent has died or lost a job.

"It would actually increase the number of uninsured children," the deputy commissioner in New York's Office of Health Insurance Programs, Deborah Bachrach, said. "We think it's bad policy."

New York has applied to expand its program coverage to families with incomes up to 400% of the poverty level — a threshold that many say the program was not intended to serve. Under the New York policy, a family of three earning as much as $68,680 could participate. In its request to expand eligibility, the state said it would enact a six-month waiting period. Currently, the state has none.

The one-year wait is "simply unconscionable," Ms. Bachrach said. "New York could not agree to that."

Many of the state Medicaid directors who participated in a conference call Wednesday to discuss the guidelines were upset.

"Not having any coverage for a year flies in the face of the health care reform efforts the states have been undertaking," the director of the National Association of State Medicaid Directors, Martha Roherty, said. The one-year minimum applies to states that extend program coverage to more moderate-income families — specifically, to families whose income exceeds 250% of the federal poverty level, or $43,925 for a family of three.