Federal health officials now get the chance to say yes or no to a proposal by the State of Louisiana to expand health care coverage to more uninsured children.

The proposal is the result of legislation passed this year in Louisiana (Act 407) that is designed to insure more children by expanding eligibility. (The new law gives Louisiana authority to allow families earning up to 300 percent of the Federal Poverty Level to qualify, but new regulations enacted at the federal level only allow eligibility up to 250 percent of the poverty level.)

Currently, only children in families earning up to 200 percent of the poverty level could qualify. This is the difference between a family of four earning $3,442 monthly today, and expanding coverage to families earning up to $4,303 monthly.

The proposal to the federal government is technically termed an amendment to Louisiana’s State Children’s Health Insurance Program (SCHIP). The amendment must be approved by the federal Centers for Medicare and Medicaid Services (CMS) before it can be implemented in Louisiana.

Since the bill’s enactment, LDH has moved quickly to define rules and set up processing steps for this newly eligible population. The department is partnering with the state Office of Group Benefits as it designs and implements this program that will be modeled similar to a private insurance plan.

It is being proposed that families qualifying under this new phase of LaCHIP will be required to pay a $50 monthly premium for coverage as well as co-payments when they access services. To discourage families from dropping private or employer-based insurance in favor of the new LaCHIP benefits, LDH has included a 12-month waiting period in the revised plan. If a family discontinues private insurance, unless they qualify for one of the limited "good cause" reasons, they will have to wait a full year before applying for LaCHIP.

Working with the Office of Group Benefits will allow LDH officials to design a set of benefits and a network of providers that is very similar to the insurance plan used by state employees.

"Partnering with Group Benefits offers many benefits for our participants," said LDH Undersecretary Charles Castille. "In addition to us modeling this plan after theirs, we can also speed up the enrollment of children into this new program. This is a winning scenario for Louisiana as a whole due to the natural efficiencies that result when two state agencies work together."

Pending CMS approval, the new LaCHIP phase is scheduled for implementation in early 2008. For more information about LaCHIP and the program’s expansion, visit www.lachip.org or call 1-877-2LaCHIP (252-2447).