While the number of children enrolled in Medicaid more than doubled between 1987 and 2005, during roughly the same period the rate of uninsured children declined by only about 1 percent. Meanwhile, the number of children covered by private plans fell from 76 percent to 63 percent. These figures suggest that Medicaid and NC Health Choice are not only failing to substantially reduce the number of uninsured children in North Carolina, but may be exacerbating the problem. Making insurance affordable for more families will reduce the number of uninsured children while reducing dependency on an unpopular government program. Likewise, bringing more children into the private insurance market will help lower costs for all North Carolinians.
Provide premium assistance for children from poorer families
By means of NC Health Choice and NC Kids Care, the state currently provides insurance coverage to hundreds of thousands of children throughout North Carolina. The state should get out of the insurance business and instead offer premium assistance to poorer families to enable them to purchase their own insurance on the private market. This initiative would function as an alternative to NC Health Choice and Medicaid, with premium assistance available for children otherwise eligible for these programs. The subsidies would be rewarded on a sliding scale and could be used to pay for virtually any healthcare and insurance expenses, including premiums, deductibles, co-payments and health savings account (HSA) deposits. Three states – Massachusetts, Connecticut and Vermont – have already established premium subsidy programs. Several other states (California, Colorado, Illinois, Kansas, Oregon, Washington and Minnesota) likewise considered such legislation in 2007 and 2008.
Allergy Waiver Saves $1,200 a Year
A 2002 report by the National Association of Health Underwriters (NAHU) found that an allergy waiver saved one client more than $100 per month. “The lowest monthly premium with a rider (waiver) was $111, and the projected average cost of her allergy medicine was $31 per month, amounting to an effective monthly cost of $142,” found NAHU. “The average monthly premium without a rider was $257.”
Reinstitute the children’s health insurance tax credit
Permit taxpayers to deduct as a personal exemption premiums paid to insure dependents. A similar tax credit was passed in 1998 (but then repealed in 2001) as part of the compromise that led to the creation of NC Health Choice.
Provide more options for children and others with mild chronic conditions
Authorize waivers to allow children and others with mild chronic ailments (such as allergies or asthma) to waive coverage for that specific ailment while retaining coverage for all other mandated providers and services. This would provide more options for at-risk populations (both children and adults) having difficulty finding affordable insurance. According to the Council for Affordable Health Insurance, more than 20 states allow such waivers – the most common waiver being for allergies.