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Access to health care, especially during the developmental years of early childhood, is critical for children and can have an impact on health outcomes well into adulthood.  We hope that the legislature will take steps to ensure that a new system of care adequately meets the needs of our state’s uninsured children.  In 2010, the number of uninsured children in the state increased significantly to an estimated 47,000.  Over half of these, 30,000 children, were considered low-income, meaning they should qualify for Medicaid or Kids Connection.  The state could increase outreach and enrollment efforts to this population now to help ensure a more seamless transition to universal coverage.

One of the essential issues to consider in moving forward on implementation is how the new health care exchanges will interact with Medicaid and Kids Connection.  The “no wrong door” enrollment policies should be made as simple as possible by maximizing the use of data matching.  Wherever possible, public benefit program requirements should also be streamlined to allow for ease of enrollment.

Steps should also be taken to minimize disruptions in coverage based on fluctuations in income.  Disruptions in coverage can be particularly problematic for children with chronic conditions and can delay well-child visits or immunizations.  Nebraska could use 12 month continuous eligibility for all Medicaid and Kids Connection enrollees and use projected annual income for all Medicaid beneficiaries in order to minimize coverage disruptions.

In addition to being an opportunity to provide health care access to underserved populations, the ACA contains a number of federal grant opportunities which can help improve the delivery of care for children and other vulnerable populations in our state.  We urge the legislature to work with  the Department of Health and Human Services to maximize the current funding opportunities available to improve service delivery in Nebraska.

Although there are still questions to be answered by the federal government, many states have moved forward on beginning to design new systems to improve health care access in their state.  We urge the legislature not to delay moving forward in Nebraska as there are critical questions to be answered that require thoughtful and thorough consideration.

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