CCS/HS/SS#2/SCS/SB 632 - This act expands health care coverage for children. It extends coverage under the Department of Social Services (Department) to include uninsured Missouri children under 19 years of age from families under 300% of the federal poverty level. Coverage may be provided for children from families with income of less than 300% of poverty level ($49,000 for a family of four).

Medicaid in the past provided coverage for children under the age of 1 up to 185% of the poverty level, to the age of 6 up to 133% of the poverty level, and through age 18 up to 100% of the poverty level.

Children under the age of 19 from families between 186% and 225% of poverty are covered under this expanded program if they have been uninsured for six months. For these children, a $5 co- payment is required with each doctor visit. Children from families between 226% and 300% of poverty are eligible for extended Medicaid only if they can prove that they do not have access to affordable health care insurance. Affordable health care insurance is defined in this act as insurance that includes premiums less than or equal to 133% of the state's health care plan. At current levels, this equals about $87 per month. These families are responsible for premiums and co-payments equal to the state's consolidated health care plan. Currently, the average state health care premium is $65 per month. Doctor visits require $10 co-payments, and prescriptions require $5 co- payments. Families with total assets greater than $250,000 are not eligible for this expanded program.

This act requires a 30 day waiting period before coverage begins, and families must wait 6 months before re-entering the program if they miss their cost sharing responsibilities. The Department of Social Services is authorized to commission a study one year after the program's implementation to study the negative effects of this new program on private health insurance coverage. The Department is also required to explain the methodology it uses to determine eligibility and cost sharing by rule.

Up to 10% of federal funding and up to 10% of state funding can be use for outreach programs through the Division of Medical Services for the programs established by this act. All provisions of this act shall be subject to appropriations.

The program will terminate in the year 2002.
JOHN MESSMER