Strict state health-care plan helps only 5 sick kids: Ohio won’t consider easing rules until court rules on using tobacco money [The Columbus Dispatch, Ohio]

July 23--Enrollment in a 2-year-old health-care program for middle-class children who are expensive or even impossible to insure because of chronic ailments has more than doubled -- to five.

That's up from two children in the months after the Children's Buy-In Program was launched April 1, 2008.

Despite far-lower-than-projected participation, state officials have put on hold planned modifications aimed at boosting enrollment while a legal dispute about the program's funding source is settled.

"It's in a holding pattern," said Benjamin Johnson, spokesman for the Ohio Department of Job and Family Services.

The program was to be paid for with $2.2 million in state tobacco-settlement money, which has been tied up in litigation.

The buy-in program provides insurance coverage to children in families earning three times the federal poverty level or more. For a family of four, that's an annual income of $66,150 or more.

To qualify, children must have a chronic or pre-existing condition and must have been uninsured for at least six months. They also must be unable to obtain insurance, or private coverage costs must be at least double what their families would pay in the state program.

Families contribute to the cost of the program, with fees ranging from $252 a month to the full cost of $505, depending on their income.

According to the state, 1,024 children in 707 families have applied for the buy-in program since its inception. Of them, 18 children were approved and eight have been enrolled. Five are currently enrolled.

State officials had projected the program would enroll 4,000 youngsters.

Medicaid administrators determined early on that many families who applied for coverage did not qualify because their incomes were too low and others had not gone long enough without insurance. In response, plans were made to reduce the waiting period to three months and allow for exceptions under certain circumstances, such as a parent losing a job and health coverage.

Mary Wachtel of the Ohio advocacy group Voices for Children said the high cost, waiting period and lack of awareness about the program contributed to low enrollment.

It's unclear how many children meet eligibility guidelines. There are about 10,000 uninsured youngsters with family incomes more than three times the federal poverty level, and a small portion of those would have pre-existing or chronic conditions.

"It's always been a niche program, but it shouldn't be an inaccessible program," Wachtel said.

She also noted that the national health-care overhaul will provide additional options to these children. For example, beginning in September, children with pre-existing conditions cannot be denied coverage by insurance companies. In addition, a state-subsidized high-risk pool will provide coverage to Ohioans of all ages.

Johnson said modifications to the buy-in program won't be made until the state learns whether resources earmarked for the program will be available.

The Ohio Supreme Court is expected to rule this year whether Gov. Ted Strickland and legislative leaders can tap a portion of the state's $10.6 billion share of a settlement between cigarette companies and the state that had been set aside to combat tobacco use.

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