By Charles Bruner and Carrie Fitzgerald
Since 2007, Iowa’s state government and the federal government have taken significant steps to expand public health coverage programs for children.
At the federal level, the Child Health Insurance Program Reauthorization Act of 2009 (CHIPRA) gave both options and incentives for states to streamline their eligibility procedures, to cover children up to 300 percent of poverty without a federal waiver, and to cover lawfully residing immigrant children without a five-year waiting period.
At the state level, Iowa lawmakers and Governor Culver took advantage of nearly all federal options under CHIPRA for Iowa’s CHIP program, hawk-i (Healthy and Well Kids in Iowa). In Medicaid they established the Family Opportunity Act for children with disabilities to stay covered up to 300 percent of poverty and streamlined eligibility for both Medicaid and hawk-i. With the federal government paying the major share for children’s health coverage under these programs, Iowa lawmakers appropriated the needed matching state funds to provide for these expansions through state fiscal year 2011.
Since 2007, 60,000 more children now are covered in either Medicaid or hawk-i.
— In April 2007, 202,741 children in Iowa were covered by Medicaid or hawk-i.
— Three years later, in April 2010, 262,634 children in Iowa were covered.
— The percentage of children under 18 covered in Iowa under Medicaid or hawk-i grew from 28.5 percent to 36.9 percent of all children.
Information on the growth in coverage of Iowa children by U.S. congressional district is below. The Fifth District, in western Iowa, has the highest proportion of children covered by these programs, 41.2 percent of all children.
Growth in children’s coverage occurred across the state. All counties experienced growth in the number and proportion of children covered under Medicaid and hawk-i. The number of children served in an Iowa House district from 2007 to 2010 grew on average by 599 children overall, with 126 of those covered by hawk-i — with double those amounts in Iowa Senate districts.
This growth in coverage cannot all be attributed to program changes. The recession and loss of employment and health coverage increased the need for these programs. Plus, rising private health insurance costs, particularly for family coverage, may have reduced the availability or affordability of private health plans covering children. From 2006 to 2008, an estimated 40,000 Iowa children were uninsured at any one time (most recent federal figures), with a higher figure uninsured at some time during the year. Recent state and federal actions provide much greater health coverage options for uninsured children in Iowa. The increase in public coverage may not cover all uninsured children, but has gone a long way to ensuring that children have access to care. The increase in children covered under Medicaid and hawk-i shows parents value and use these programs for their children.