Conceived in 1997 and implemented on May 1, 1998, the plan, which is funded approximately 75 percent with federal money and 25 percent by the state, serves children from birth to age 18. For $10 per month, a family can buy a policy for each of its eligible children that provides health insurance coverage identical to that of a state employee, including dental, from one of seven insurance companies.
Edmund Kemp, director of the Medicaid Policy Division, with 30 plus years of experience in government, and Logan Dreasky, manager of the Eligibility Section, originally from Flint and back in Michigan after a stint in Baltimore (and described by Kemp as the “go to guy” for MI Child), say that currently the number of children covered stands at approximately 30,000.
The number peaked at about 36,000 in 2008. Both attribute the declining enrollment to policy changes and “the economy [going] south,” with the Medicaid rolls growing proportionally.
They estimate that as many as 60,000 more children may be eligible for MI Child, but say that finding them, and getting their families to sign up, hasn’t been easy. This is particularly frustrating, because additional federal matching funds are available—assuming that the Michigan Legislature continues to find enough money in its budget to fund the state’s portion of the program.
As Kemp explains, “That’s been one of the factors the last couple of years because of the economy. We’re always looking for that general fund money to match all the Medicaid services.” If necessary matching funds aren’t available, there’s the potential for the federal money to go back “into the match” to be used by other states with sufficient matching funds. “We have a pretty generous allotment and we never use it all,” Kemp says.
Working from grants, the Primary Care Association and the YMCA have conducted outreach initiatives to find children eligible for the program. However, according to Dreasky,”For every one kid we find for the MI Children program, we find three that are Medicaid eligible.” Premiums cost the state just under $100 per month per child (less the $10/month from the families) versus $300 to $350 for the typical insurance coverage. For their medical needs, the vast majority (almost 88 percent) of local children are covered by Blue Cross Blue Shield of Michigan. For their dental plans, almost an equal number are served by BCBSM and Delta Dental.
Considering what a bargain the program is, one has to wonder why more eligible families aren’t enrolling their children. Edmund speculates that part of the reason could be that some families don’t want to be seen as taking handouts. For others, it could be a case of not wanting Uncle Sam to be involved in their healthcare. MI Child statistics show that prospective families learn about the program chiefly from friends/other family members (31 percent) and the Department of Human Services (17 percent); 11.5 percent is accounted for by “other,” and the Internet for nearly nine percent. One other category accounts for more than four percent.
Not surprisingly, southeast Michigan is home to the majority of the program’s children. MI Child serves only about 1,000 children in Ingham, Eaton, and Clinton counties combined.
Asked if the extremely low premiums could serve as a disincentive for parents of enrolled children to find work that puts them over the 200 percent federal poverty level limit, Edmund and Dreasky agree that it is possible, but that it’s hard to determine whether or not that’s happening. They say that periodic audits and spot checks of enrolled families show a very low incidence of abuse or misuse, even though the program relies on self-declaration of a family’s income.
Other noteworthy particulars of the program for those who may be considering applying or may know someone who could benefit from MI Child:
• When calculating a family’s income, “earned income” is disregarded.
• If you have daycare expenses, $200 per month is taken off your income when calculating whether or not you are eligible.
• Child-support payments are considered the child’s income, and don’t count toward the family income. Likewise with any income a child receives from a job.
• If your family qualifies, each child is automatically given 12 months of eligibly. If the family starts earning more than the maximum income after the child is enrolled, he/she is still covered. When renewal time comes around, if your income drops to the 200 percent level or below, the child(ren) can continue being covered. This is a boon to seasonal workers.
• Families can come in and out of the program on a monthly basis. If a wage-earner gets a job that includes family health insurance, the family can drop out of MI Child immediately.In short, both agree that the program is “extremely lenient.” Dreasky concludes by saying, “If you think you’re close, apply.” Find out in 30 minutes or less if your family is likely to be eligible by visiting the MI Child website and clicking on Start Application at the bottom of the page.
State of MIchigan
Edmund Kemp, Director Medicaid Policy Division
Logan Dreasky, Manager Eligibility Section Medicaid Policy Division