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The Louisiana Family Opportunity Act Medicaid Buy-in Program

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Abstract

Objectives

The Family Opportunity Act Medicaid Buy-In Program (FOA) allows states to expand Medicaid coverage to children who meet selected disability and income eligibility criteria. FOA programs may help address family financial hardship as a result of underinsurance. We provide specific information about the FOA program and report the first results of a survey of parents or guardians of children with disabilities who were enrolled in Louisiana’s FOA program.

Methods

A convenience sample of families enrolled in the program (N = 52) responded to questions derived from the National Survey of Children with Special Health Care Needs (CSHCN). These results were compared to two groups of Louisiana families of CSHCN that had responded to the 2009/10 national survey.

Results

Data suggest that children enrolled in the Louisiana FOA are younger than those enrolled in Supplemental Security Income, are more likely to have functional losses, and, perhaps due to their age, are less likely to have difficulty with anxiety, depression, or behavior problems. FOA families are less likely than families in either group to report receiving help with care coordination, and more likely to report financial problems due to their child’s health. Respondents were also more likely to report that they received all the therapy services and specialty care they needed.

Conclusions

The FOA program thus appears to be filling a niche in coverage needs among families of children with disabilities in Louisiana.

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References

  1. Abraham, J. M., DeLeire, T. & Royalty, A. B. (2009). Moral hazard matters: Measuring relative rates of underinsurance using threshold measures, Working Paper 15410. NBER. Cambridge, MA. www.nber.org/papers/w15410. Downloaded August 20, 2012.

  2. American Academy of Pediatrics. (2012). A comparative review of essential health benefits pertinent to children in large federal, state and small group health insurance plans: implications for selecting state benchmark plans. http://www.aap.org/en-us/about-the-aap/aap-press-room/Documents/AAP_EHB_Report_FinalPress.pdf. Downloaded September 4, 2012.

  3. Assistant Secretary for Planning and Evaluation (ASPE) Department of Health and Human Services. (2015). 2015 poverty guidelines. Retrieved May 25, 2015 from http://aspe.hhs.gov/poverty/15poverty.cfm.

  4. Bachman, S. S., Comeau, M., Tobias, C., Allen, D., Epstein, S., Jantz, K., & Honberg, L. (2012). State health care financing strategies for children with intellectual and developmental disabilities. Intellectual and Developmental Disabilities, 50(3), 181–189.

    Article  PubMed  Google Scholar 

  5. Bennett, K. J., & Dismuke, C. E. (2010). Families at financial risk due to high ratio of out-of-pocket health care expenditures to total income. Journal of Health Care for the Poor and Underserved, 21(2), 691–703.

    Article  PubMed  Google Scholar 

  6. Centers for Disease Control and Prevention, National Center for Health Statistics, State and Local Area Integrated Telephone Survey. (2011). 2009–2010 national survey of children with special health care needs frequently asked questions. http://www.cdc.gov/nchs/slaits/cshcn.htm. Accessed 08/14/12.

  7. Chen, A. Y., & Newacheck, P. W. (2006). Insurance coverage and financial burden for families of children with special health care needs. Ambulatory Pediatrics, 6(4), 204–209.

    Article  PubMed Central  PubMed  Google Scholar 

  8. Data Resource Center for Child and Adolescent Health. (2015). Indicator 13. CSHCN whose families experienced financial problems due to child’s health conditions. Retrieved May 20, 2015 from http://www.childhealthdata.org/browse/survey/results?q=1632&r=1.

  9. Deficit Reduction Act of 2005 (2006). Chapter 6—Other provisions, Subchapter A—Family Opportunity Act. Section 6061: Opportunity for Families of Disabled Children to Purchase Medicaid Coverage for Such Children. Public Law 109-171.

  10. DeVoe, J. E., Tillotson, C. J., Angier, H., & Wallace, L. S. (2014). Recent health insurance trends for US families: Children gain while parents lose. Maternal and Child Health Journal, 18, 1007–1016.

    Article  PubMed  Google Scholar 

  11. Feist, D. (2007). A Broader Medicaid Program. Retrieved May 25, 2015 from http://www.behavioral.net/article/broader-medicaid-program.

  12. Gabel, J. R., McDevitt, R., Lore, R., Pickreign, J., Whitmore, H., & Ding, T. (2009). Trends in underinsurance and the affordability of employer coverage, 2004–2007. Health Affairs, 28(4), w595–w606.

    Article  PubMed  Google Scholar 

  13. Ghandour, R. M., Perry, D. F., Kogan, M. D., & Strickland, B. B. (2011). The medical home as a mediator of the relation between mental health symptoms and family burden among children with special health care needs. Academic Pediatrics, 11(2), 161–169.

    Article  PubMed  Google Scholar 

  14. Herman, P. M., Rissi, J. J., & Walsh, M. E. (2011). Health insurance status, medical debt, and their impact on access to care in Arizona. American Journal of Public Health, 101(8), 1437–1443.

    Article  PubMed Central  PubMed  Google Scholar 

  15. Kalousova, L., & Burgard, S. A. (2013). Debt and foregone medical care. Journal of Health and Social Behavior. doi:10.1177/0022146513483772.

  16. Kogan, M. D., Newacheck, P. W., Blumberg, S. J., Ghandour, R. M., Dingh, G. K., Strickland, B. B., & van Dyck, P. C. (2010). Underinsurance among children in the United States. The New England Journal of Medicine, 363(9), 841–851.

    Article  CAS  PubMed  Google Scholar 

  17. Kogan, M. D., Newacheck, P. W., Honberg, L., & Strickland, B. (2005). Association between underinsurance an access to care among children with special health care needs in the United States. Pediatrics, 116(5), 1162–1169.

    Article  PubMed  Google Scholar 

  18. Louisiana Department of Health and Hospitals. (2007). Declaration of emergency. Retrieved May 25, 2015 from http://doa.louisiana.gov/osr/emr/0710EMR050.htm.

  19. Louisiana Department of Health and Hospitals. (2014). Louisiana medicaid eligibility manual. Retrieved May 25, 2015 from http://new.dhh.louisiana.gov/assets/medicaid/MedicaidEligibilityPolicy/H-2300.pdf.

  20. Lukemeyer, A., Meyers, M. K., & Smeeding, T. (2000). Expensive children in poor families: Out-of-pocket expenditures for the care of disabled and chronically ill children in welfare families. Journal of Marriage and the Family, 62(2), 399–415.

    Article  Google Scholar 

  21. McPherson, M., Arango, P., Fox, H., Lauver, C., McManus, M., Newacheck, P. W., et al. (1998). A new definition of children with special health care needs. Pediatrics, 102, 137–140.

    Article  CAS  PubMed  Google Scholar 

  22. National Survey of Children with Special Health Care Needs. NS-CSHCN 2009/10. Data query from the child and adolescent health measurement initiative, data resource center for child and adolescent health website. Retrieved 8/30/12 from www.childhealthdata.org.

  23. Oswald, D. P., Bodurtha, J. N., Willis, J. H., & Moore, M. B. (2007). Underinsurance and key health outcomes for children with special health care needs. Pediatrics, 119(2), e341–e347.

    Article  PubMed  Google Scholar 

  24. Parish, S. L., Rose, R. A., Dababnah, S., Yoo, J., & Cassiman, S. A. (2012). State-level income inequality and family burden of US families raising children with special health care needs. Social Science and Medicine, 74(3), 399–407.

    Article  PubMed  Google Scholar 

  25. Parish, S. L., Shattuck, P. T., & Rose, R. A. (2009). Financial burden of raising CSHCN: Association with state policy choices. Pediatrics, 124(Supplement 4), S435–S442.

    Article  PubMed  Google Scholar 

  26. Social Security Administration. (2015). Disability evaluation under social security: Listing of impairments, childhood listings. Retrieved May 25, 2105 from http://www.ssa.gov/disability/professionals/bluebook/ChildhoodListings.htm.

  27. The Catalyst Center. (2015). Buying into a Medicaid Buy In Program. Retrieved May 25, 2015 from http://www.hdwg.org/catalyst/case-studies/TX-medicaid-buy-in.

  28. U.S. Department of Health and Human Services. (2015). Early and periodic screening, diagnosis and treatment. Retrieved May 25, 2015 from http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Benefits/Early-Periodic-Screening-Diagnosis-and-Treatment.html.

  29. U.S. Government Printing Office. (2005). Text of the Deficit Reduction Act of 2005. Retrieved May 25, 2015 from http://www.govtrack.us/congress/bills/109/s1932/text.

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Acknowledgments

This research was conducted with support from The Catalyst Center, the National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs, under grant number U41MC13618 ($473,000) from the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS). This information and its content and conclusions are those of the authors and should not be construed as being endorsed by or as the official position or policy of HRSA, HHS, or the U.S. Government.

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Authors and Affiliations

  1. Health and Disability Working Group, Boston University School of Public Health, 715 Albany Street, Boston, MA, 02118, USA

    Sara S. Bachman, Meg Comeau, Beth Dworetzky, Rose Hamershock & Melissa Hirschi

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  1. Sara S. Bachman
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  2. Meg Comeau
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  3. Beth Dworetzky
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  4. Rose Hamershock
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Correspondence to Sara S. Bachman.

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Bachman, S.S., Comeau, M., Dworetzky, B. et al. The Louisiana Family Opportunity Act Medicaid Buy-in Program. Matern Child Health J 19, 2568–2577 (2015). https://doi.org/10.1007/s10995-015-1775-1

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