ALL Kids enrollment expected to rise

MONTGOMERY — As the state prepares to unenroll Alabamians from the Medicaid program for the first time in three years, a publicly supported, low-cost health care program for children is preparing for an increase in enrollment.

The Alabama Department of Public Health would receive a $34 million, 44% General Fund increase next year under the budget proposal Gov. Kay Ivey recently sent lawmakers.

Almost all of the new money is related to the expected uptick in enrollment in the Children's Health Insurance Program, also known as CHIP or ALL Kids, State Health Officer Dr. Scott Harris told Alabama Daily News recently.

"Almost all that increase you see in the budget is expected to be the state's share, we're paying for what we expect to be a big jump in CHIP enrollment," Harris said.

All Kids' enrollment is currently 69,932. ADPH expects to add about 15,000 to 20,000 more over the next year as Medicaid rolls are reduced.

Harris said CHIP's enrollment did decrease during the pandemic as more families were on Medicaid.

After a three-year federal requirement not to remove people from Medicaid rolls during the public health emergency, Alabama and other states will soon be able to start disenrolling people who now earn too much to qualify for the insurance program for the low-income and disabled.

About 1.3 million Alabamians are currently receiving Medicaid benefits, up from 1.05 million before the COVID-19 pandemic. Reviewing all recipients' eligibility statuses will take about a year.

But Medicaid's income requirements are lower than ALL Kids. For children and pregnant women to qualify for Medicaid, a family of four this year has to earn $43,800 or less. To qualify for ALL Kids, it's $90,000 for a family of four. Premiums range from $52 to $104 per child, per year.

Unlike Medicaid, ALL Kids uses Blue Cross and Blue Shield to provide medical, mental health, and substance abuse services through its preferred provider network.

About half of Alabama children are on Medicaid and about 3% of children don't have health insurance, a rate that is better than many states.

While some children whose families no longer qualify for Medicaid will be picked up by ALL Kids, the Medicaid unwinding will result in more uninsured adults, Harris said.

County health departments around the state provide health services such as immunizations, family planning and treatment for sexually transmitted diseases. Harris said many of the Alabamians the departments see are on Medicaid, but it serves people with no insurance or ability to pay as well.

"We'll have more people with no ability to pay and less people who have Medicaid for which we can get reimbursed," Harris said about the Medicaid enrollment change.

Outside of the ALL Kids increase, Harris said ADPH requested about $3 million to hire staff at county health departments around the state.

"We've lost about 75 environmentalists at the county level in the last 10 to 12 years," Harris said. "This won't allow us to get them all back, but we are trying to hire."

Health department environmentalists perform restaurant inspections, issue water and septic permits, and respond to animal bites, among other duties, Harris said.