Originally created 05/14/98

Health cost called high



ATLANTA -- A state plan to supply cut-rate health insurance to more than 100,000 children won praise Wednesday from advocates for the poor, though some suggested the coverage should be easier to get.

Critics said the rates proposed by the Department of Medical Assistance -- $7.50 a month for one child over 6 and $15 for two or more -- will price some families out of the coverage.

They also questioned why the insurance is available only to families who have been without private policies for three months, a compromise with insurance companies concerned that their customers would drop regular coverage to get cheaper state insurance.

"We need to do a lot of work to make sure the premiums don't become a barrier," Linda Lowe, a lobbyist for the nonprofit group Families First, told members of the state Medical Assistance board Wednesday.

The $70 million program was mandated by Congress and approved by state legislators this year. It is aimed at families that earn too much to qualify for free health coverage under Medicaid but not enough to afford private insurance.

To qualify for regular Medicaid, a family of four with children over age 6 would have to earn less than $21,879 a year. To get the state-subsidized insurance, that family could earn as much as $32,900.

The first customers will be signed up in the Macon area in September, with coverage to begin in November. If that trial run goes well, the insurance should go on sale statewide in December, with coverage taking effect in January.

Officials say 113,000 to 140,000 children will qualify for the benefits, which will cover dental care, mental health and prescription drugs as well as physician and hospital services.

"The benefit package is extremely generous. It is far and away more generous than any package of private benefits that is available for purchase in this state," said Margaret Taylor, Medicaid deputy commissioner.

Ms. Taylor explained details of the program Wednesday at a hearing at which health-care experts gave the proposal generally favorable reviews.

Among the suggested changes was letting people who are turned down for coverage appeal the denial before a state hearing officer, and making it easier to get routine dental visits covered without prior state approval.

Officials at Medical Assistance, which runs Medicaid as well as the children's program, promised to consider the public suggestions as they decide how the coverage plan will work.

One detail still to be addressed is what to call it. The General Assembly named the initiative "PeachCare," but Medical Assistance officials discovered the name was already in use by a private company. They are searching for a substitute.

BYLINE1:By Frank LoMonte

BYLINE2:Morris News Service

ATLANTA -- A state plan to supply cut-rate health insurance to more than 100,000 children won praise Wednesday from advocates for the poor, though some suggested the coverage should be easier to get.

Critics said the rates proposed by the Department of Medical Assistance -- $7.50 a month for one child over 6 and $15 for two or more -- will price some families out of the coverage.

They also questioned why the insurance is available only to families who have been without private policies for three months, a compromise with insurance companies concerned that their customers would drop regular coverage to get cheaper state insurance.

"We need to do a lot of work to make sure the premiums don't become a barrier," Linda Lowe, a lobbyist for the nonprofit group Families First, told members of the state Medical Assistance board Wednesday.

The $70 million program was mandated by Congress and approved by state legislators this year. It is aimed at families that earn too much to qualify for free health coverage under Medicaid but not enough to afford private insurance.

To qualify for regular Medicaid, a family of four with children over age 6 would have to earn less than $21,879 a year. To get the state-subsidized insurance, that family could earn as much as $32,900.

The first customers will be signed up in the Macon area in September, with coverage to begin in November. If that trial run goes well, the insurance should go on sale statewide in December, with coverage taking effect in January.

Officials say 113,000 to 140,000 children will qualify for the benefits, which will cover dental care, mental health and prescription drugs as well as physician and hospital services.

"The benefit package is extremely generous. It is far and away more generous than any package of private benefits that is available for purchase in this state," said Margaret Taylor, Medicaid deputy commissioner.

Ms. Taylor explained details of the program Wednesday at a hearing at which health-care experts gave the proposal generally favorable reviews.

Among the suggested changes was letting people who are turned down for coverage appeal the denial before a state hearing officer, and making it easier to get routine dental visits covered without prior state approval.

Officials at Medical Assistance, which runs Medicaid as well as the children's program, promised to consider the public suggestions as they decide how the coverage plan will work.

One detail still to be addressed is what to call it. The General Assembly named the initiative "PeachCare," but Medical Assistance officials discovered the name was already in use by a private company. They are searching for a substitute.