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2007 Enacted State Legislation Related to Children and Access to Health Care

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Overview

As of December 31, 2007, 1,771 bills related to access to health care for children had been introduced in the 50 state legislatures during the calendar year.  Of these 1,771 bills, 304 became law in 27 states and the District of Columbia.

A broad range of issues related to children’s access to health care were addressed during the legislative sessions including increasing the maximum age of dependents for private health insurance, payment of medical benefits in child support cases, mandatory health insurance benefits, extending the age at which foster children are eligible to receive Medicaid, establishing outreach programs for SCHIP and requiring the development of certain school policies.

Several states—Hawaii, New York, Ohio, Oklahoma and Washington—passed legislation to expand access to health care for children.  Hawaii’s plan created a three-year pilot program to provide subsidized coverage to newborns and children up to 19 years of age with family incomes up to 300 percent of the federal poverty level.  Authorized immigrants, who are otherwise barred from receiving public health benefits for five years under the welfare reform law, were also included in the plan.  Oklahoma passed legislation to expand Medicaid eligibility to children up to 18 years of age from 185 percent of poverty to 300 percent of poverty.  Washington passed legislation ensuring access to health care for “all kids.”  The Healthy Washington Initiative, as it is called, expanded coverage for children under 19 in families earning up to 250 percent of poverty, regardless of immigration status, and provides a buy-in option for children at higher incomes.

Following a directive issued by the Centers for Medicare & Medicaid Services on August 17, 2007, however, states wishing to expand SCHIP coverage beyond 250 percent of poverty must meet a set of criteria before opening up the rolls to higher income children—for example, prove that at least 95 percent of children with incomes under 200 percent of pverty are already covered, and require that children have been uninsured for at least one year before being enrolled in SCHIP—or face rejection of their proposals by CMS (see SHN #515, 5/12/2008).  As a result, plans to expand coverage for children have been put on hold or are being implemented using state funds only.

Bills that mentioned children and/or access to health care but whose focus was much broader than children were not included in the summary below.  Similarly, bills that established commissions or review committees, or those that amended administrative aspects of children’s health programs or clarified program rules, but did not fundamentally alter access to care by children, were not included. Vetoed bills also were excluded.

 

State Legislative Activity By Topic

 

Benefit Mandate

Delaware  SB 78  (Enacted 8/1/2007)
This bill requires health insurance plans to cover formula and other physician recommended treatments for babies born with Phenylketonuria (PKU) and other inherited metabolic diseases.   

Illinois HB 1628 (Enacted 10/17/2007)
The bill amends the Covering ALL KIDS Health Insurance Act by removing copayment and coinsurance requirements for services under the Covering ALL KIDS Health Insurance Program. It also allows the Department of Healthcare and Family Services to specify the necessary criteria and conditions that must be met in order for an enrollee to obtain a standing referral.  Outlines case management and performance standards.

Minnesota  SF 805  (Enacted 5/10/2007)
The law requires health plans to cover hearing aids for children 18 years of age and under for any hearing loss not correctable by other covered procedures.   

New Hampshire SB 93  (Enacted 7/16/2007)
The law mandates insurance coverage for the costs of early intervention services for children up to 36 months.

 
Expanded Coverage for Children

Hawaii HB 1008  (Enacted 5/7/2007)
This bill creates three-year pilot programs referred to as Hawaii's Child Health Care and Infant Care Programs.  Under the pilot, half of the cost of health care premiums will be paid for uninsured children who are ineligible for other state and federal coverage.  For uninsured newborn children between one and 30 days of age, continuous service will be provided through the Hawaii Infant Care Program; these children are eligible to enroll in Hawaii’s CHIP program upon reaching 31 days. The bill also provides access to medical care for certain children below 19 years of age whose family income is at or below 300 percent of poverty and are legal permanent residents who arrived after August 22, 1996 (Under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, most children who arrive in the United State after August 22, 1996 are barred from state benefits for five years).

New York AB 4308  (Enacted 4/9/2007)
The 2007-2008 state budget bill expands coverage for children from 250 percent to 400 percent of poverty.  In addition, the legislation includes a sliding scale of premiums, depending on family income; imposes a 6month waiting period for children with access to employer-sponsored health coverage before enrolling in the state’s children’s health program; streamlines enrollment and recertification processes into Medicaid and SCHIP; provides premium assistance to purchase employer sponsored health insurance to families with incomes between 250 percent and 400 percent of poverty; mandates participation in the premium assistance program for children living in families with incomes between 250 percent and 400 percent of poverty.

Ohio HB 119  (Enacted 6/30/2007)
The state budget bill raised the Medicaid eligibility for pregnant women from 150 percent to 200 percent of poverty; raised the Medicaid/SCHIP eligibility for Ohio children from 200 percent of poverty to 300 percent of poverty and increased the age at which foster children lose Medicaid benefits from 18 to 21 years of age.  The law also creates the Children’s Buy-In program that allows children living in families with incomes above 300 percent of poverty to buy into public health benefits on a sliding scale. The program can be implemented regardless of whether the Medicaid state plan amendment, waiver request, or both are denied.  The act provides that the program is to be funded with state funds only if the United States Secretary denies federal matching funds for the program.

Oklahoma SB 424  (Enacted 6/4/2007)
The legislation creates the All Kids Act, which requires the State Health Care Authority to expand Medicaid eligibility for children up to 18 years of age from 185 percent of poverty to 300 percent. The All Kids Act will go into effect on or before January 1, 2011.

Washington SB 5093  (Enacted 3/13/2007)
The measure establishes the Healthy Washington Initiative, which seeks to expand affordable health care coverage to children under the age of 19 living in families with incomes up to 250 percent of poverty and, to the extent that funds are appropriated henceforth, to children in families with annual incomes up to 300 percent of poverty.  Unauthorized immigrants are included. The multifaceted bill requires each child to have a medical home, as assessed through immunization rates, ED use, preventive oral health utilization and case management for children with chronic conditions.  Also mandates that by 2010 each K-12 school district will have a health advisory committee and that only healthy food and beverages will be available on school campuses.

 
Dependent Coverage

California AB 910  (Enacted 10/13/2007)
This legislation amends sections of the Health and Safety Code, the Insurance Code and the Family Code by requiring that dependent children remain eligible for health insurance upon reaching the limiting age specified within the plan if they are continuously incapable of self-sustaining employment by reason of mental retardation or a physical disability.

Maine HB 640  (Enacted 5/14/2007)
This law requires that individual and group health insurance policies to offer coverage for a “dependent child” up to 25 years of age if the child is still dependent, has no dependents, does not have any other source of insurance and is a resident of the state or attends an accredited university. 

New Hampshire HB 790  (Enacted 7/17/2007)
The law expands the definition of dependent young adults to include those who are less than 26 years of age for purposes of health insurance coverage.

 
Child Support

Minnesota SF 1271  (Enacted 5/24/2007)
The law allows a child support order to be modified due to a change in the availability of appropriate health care coverage or a substantial increase or decrease in health care coverage costs.  The law also requires a medical child support order to include how uninsured or unremibursed medical costs for a child will be allocated between parents.

Nebraska LB 554  (Enacted 5/31/2007)
The law requires a parenting plan be developed during family proceedings involving a child.  The parenting plan must include a medical support plan allocating the costs of the child's medical care. 

New Hampshire HB 827  (Enacted 6/25/2007)
The law requires the court to address medical support as part of child support proceedings. Criteria are established for determining whether health insurance is available to parents at a reasonable cost.  If private health insurance is available at a reasonable cost, the parents are required to provide such insurance for their children.

 
Eligibility

Alaska SB 27 (Enacted 9/28/2007)
This law expands access to medical assistance for certain categories of children, pregnant women and disabled persons.  For individuals with income between 150 percent and 175 percent of poverty cost-sharing practices may be utilized.          

Minnesota HF 1078  (Enacted 5/25/2007)
The law establishes the Children's Mental Health Initiative, a pilot project with the goal of improving children's mental health service coordination, communication, and processes.  It also requires that a grant from the Oral Health Care Innovations fund be reserved for the Bright Smiles Program, a program which increases dental access to low-income and immigrant children and their families in the Minneapolis area.  The law also reaffirms federal law that undocumented noncitizens and nonimmigrants are ineligible for general assistance medical care.

Texas   HB 109  (Enacted 6/15/2007)
The bill changes CHIP income eligibility standards by defining "net family income" to mean the amount of income established after reductions for offsets for certain child care expenses and by establishing guidelines for allowable assets when calculating income for purposes of eligibility. The bill also sets continuous coverage under the program at 12 months rather than six, eliminates a 90-day waiting period except for certain applicants who were previously covered by a health benefit plan and establishes a community outreach campaign to provide information regarding CHIP through school-based health clinics and a toll-free hotline.

Washington HB 1201 (Enacted 5/4/2007)
The law extends Medicaid coverage for foster care youth from age 18 to 21.    

 
HIV/AIDS

New York  AB 8097 (Enacted 6/29/2007)
The law extends grants to programs promoting HIV services, outreach and education targeting women and children, including adolescents.

 
Immunization/Vaccines

California SB 533 (Enacted 9/14/2007)
Adds pneumococcus to the list of childhood diseases a pupil must be immunized against prior to admission to any private or public elementary or secondary school, child care center, nursery school, family day care home, or development center.           

Illinois  SB 133    (Enacted 8/24/2007)
This law amends the Mercury-Free Vaccine Act by implementing a policy of administering thimerosal-free flu vaccines, or flu vaccines with small trace amounts of thimerosal to children under the age of three, who participate in the Vaccines for Children program.  The health department will advocate that other providers also use thimerosal-free or flu vaccines low in thimerosal be utilized for children under age three.      

Illinois SB 937             (Enacted  8/24/07)
The law mandates that, depending on state funding, women under age 18 whose insurance plans do not cover the human papillomavirus (HPV) vaccines shall be eligible to receive one at no cost from the state.  The Department of Public Health shall establish the program's operating procedures.  This act also requires that all insurance plans renewed, delivered, amended or issued after August 2007 cover the HPV vaccine.  All females entering into 6th grade will be provided with written information regarding the link between HPV and cancer and about the availability of the HPV vaccine. 

Nebraska  LB 63  (Enacted 2/14/2007)
The law adds insurance certificates to requirements for insurance coverage of childhood immunizations.

Ohio    SB 58   (Enacted 5/31/2007)
The law modifies the authority of pharmacists to allow them to administer influenza immunizations to persons 14 years of age and older.

 
Lead Poisoning

Michigan  HB 4936  (Enacted 12/21/2007)
The law reinstates the Michigan Childhood Lead Poisoning Prevention and Control Commission.  The Commission is required to study and report on the environmental threats of lead poisoning to children's health, review the state's lead poisoning prevention program and evaluate the effectiveness of the program.  The Commission will also assess the prevention program's ability to meet the federal requirement that all young children enrolled in Medicaid be screened with a blood lead test.

New Hampshire  SB 176  (Enacted 7/12/2007)
The law lowers the blood lead level that determines when a child has lead poisoning and allows the commissioner of the Department of Health And Human Services to inspect other units of a multi-unit dwelling when a child has been found to be lead poisoned in one of the units.  The law also establishes a commission to study the current childhood lead poisoning prevention law, policies, and standards.

 
Mental Health

Hawaii HB 55  (Enacted 6/4/2007)
This measure allows the Department of Health to establish a youth suicide prevention and intervention program.       

Illinois SB 15  (Enacted 8/27/2007)
This law establishes the Perinatal Mental Health Disorders and Treatment Act.  The Health Department, the Board of Nurses and the Department of Financial and Professional Regulation will work with physicians, healthcare facilities, nurses and licensed health care workers to develop policies and procedures related to the prevention, treatment, and diagnosis of postpartum mood disorders in women. 

Illinois SB 51  (Enacted 8/17/2007)
Designates that a person with an "autism spectrum disorder" who may or may not also be mentally retarded, can be assessed for services under Home and Community-based Service Waivers.  The law also requires that the state disability database shall now include individuals with autism spectrum disorders.

Illinois SB 337  (Enacted  8/30/2007)
This law updates the Probate Act of 1975 by adding to the definition of a disabled person to include individuals diagnosed with fetal alcohol syndrome.  

Nebraska  LB 482  (Enacted 5/24/2007)
The law requests an amendment to a waiver under the medical assistance program to provide for the coverage of qualifying autism services for children.

New York  AB 6931  (Enacted 7/3/2007)
The law pertains to a state children's mental health plan, which is required to be based on comprehensive mental health plans developed by local governments with participation from consumers and providers.  The state plan must offer recommendations on how to deliver culturally and linguistically competent mental health assessments, services and treatment for children.

South Carolina  SB 20              (Enacted 6/18/2007)
The new law requires health insurance plans to provide coverage for treatment of pervasive developmental disorders, including autism and Asperger's Syndrome. To be eligible for benefits, an individual must be diagnosed by eight years of age.

Washington HB 1088 (Enacted 5/8/2007)
The law requires the Department of Social and Health Services to under take specified activities related to children's mental health services, including recognizing early identification, intervention, and prevention services. The law also includes assessing a child's need for such services based upon the child's diagnosis and provides for the development of a revised children's mental health benefit package through Medicaid.                 

 
Pre- and Postnatal Care

Illinois SB 1566  (Enacted  11/5/2007)
This law expands newborn genetic screenings to include tests for Lysosomal Storage Disorders known as Krabbe, Pompe, Gaucher, Fabry, and Niemann-Pick.  A fee may be charged for administering these tests to fund and initially support the program. 

Illinois HB 1759 (Enacted 11/29/2007)        
The law amends the Perinatal HIV Prevention Act by requiring that every health care professional who provides health care services to a pregnant woman shall provide the woman with HIV counseling and recommend HIV testing, unless she declines in writing or has already received an HIV test during pregnancy, provides for privacy if the infant does not have HIV or AIDS. 

Maine SB 241  (Enacted 6/6/2007)
The Department of Health and Human Services will create a committee to review existing efforts regarding the education and screening for postpartum depression.  The committee's findings will be reported to the Joint Standing Committee on Health and Human Services by January 15, 2008.

Virginia SB 1088  (Enacted 3/27/2007)
The bill creates and allows for donations into the Virginia Pregnant Women Support Fund, which will be used to support women facing unplanned pregnancies. Funds to be obtained through a grant process and can be used for activities such as upgrading equipment, supporting violence prevention, early childhood education and job training programs, and providing teen or first time mothers with free home visits from registered nurses.

 
SCHIP Outreach

New Hampshire  SB 192  (Enacted 7/16/2007)
The law establishes a public education and outreach component of the children’s health insurance program to be administered by the New Hampshire Healthy Kids Corporation.  Outreach includes the development of a volunteer program to promote the program to eligible families and to identify those families who may require assistance with the application or redetermination process. 

 

Other

Illinois SB 641 (Enacted 10/17/2007)
The legislation requires that students enrolling for the first time in a public, private or parochial school shall have an eye examination. Provides for a waiver for children with an undue burden or lack of access. Prohibits a school from excluding a child because of parental refusal.               

New York  AB 4051  (Enacted 8/15/2007)
The law enacts the Food Allergy and Anaphylaxis Management Act. The law requires that an anaphylactic policy is established for school districts for the prevention and treatment of anaphylaxis.


The above search was powered by StateNet.

The above list is intended to be as inclusive as possible. When available, links to legislation have been provided. For corrections and additions, please contact Anna Spencer at anna.spencer@ncsl.org

Prepared by:
The Forum for State Health Policy Leadership
National Conference of State Legislatures
444 N Capitol Street NW, Suite 515
Washington, DC 20001

This summary was made possible with support from the David and Lucile Packard Foundation.

Last Updated May 27, 2008

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