The Louisiana Family Opportunity Act Medicaid Buy-in Program
- 186 Downloads
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.
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.
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.
The FOA program thus appears to be filling a niche in coverage needs among families of children with disabilities in Louisiana.
KeywordsCSHCN Financial hardship Health care coverage Health insurance
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.
- 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.
- 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.
- 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.Google Scholar
- 11.Feist, D. (2007). A Broader Medicaid Program. Retrieved May 25, 2015 from http://www.behavioral.net/article/broader-medicaid-program.
- 15.Kalousova, L., & Burgard, S. A. (2013). Debt and foregone medical care. Journal of Health and Social Behavior. doi: 10.1177/0022146513483772.
- 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.
- 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.
- 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.