Obamacare rules keep kids uninsured

by Kiley Crossland
Posted 1/30/14, 11:24 am

Confusing messages and enrollment delays under Obamacare are leaving some children uninsured as the federal exchange separates children who qualify for Medicaid from parents who don’t.

The minimum eligibility threshold for safety-net programs like Medicaid is higher for children, so in some cases a child may qualify when his parents do not. Under Obamacare, children who qualify for a low-income insurance program are not allowed to be on their family’s subsidized health insurance plan purchased through the federal marketplace.

When a family registers online, the system automatically kicks out any kids who potentially could be covered by Medicaid or Children’s Health Insurance Program (CHIP), a low-cost program for kids whose parents earn too much to qualify them for Medicaid. The online system directs parents to continue with their application, but informs them that their children will not be included under any plans they purchase.

Russell Clouden, a Florida resident, found a less expensive plan on the healthcare exchange. When he tried to enroll his family, he was told his 14-year-old daughter might qualify for Healthy Kids, Florida’s CHIP program, so he could not include her on his family’s plan.

“Based on your income, they’ll separate your kids from your primary policy and they shift them off to Medicaid or Healthy Kids and there’s no way you can bring them back,” he said. His daughter’s application, along with roughly 90,000 others, has yet to be transferred from the federal government to Florida’s Medicaid office. Until her eligibility is determined, she remains uninsured.

“I have worried parents literally calling and texting me every day asking for an update,” said Matthew Dinkel, a Florida insurance broker. “They canceled their old plans that covered their entire family and now they have coverage but their kids don’t.”

Some parents who applied for Medicaid or CHIP for their kids are finding out that their children have been rejected. But at this point, parents cannot add kids to already established insurance plans. So parents have insurance, but their children don’t.

Others have received mixed signals. The California State Insurance Marketplace told Robert Clark that his two children could be on his plan, but later Clark received notices saying they had to be enrolled in the state’s Medicaid program, a prospect he doesn’t like. “It’s pretty frustrating,” he said. “We’ve probably spent several days’ worth of time on hold.”

On Tuesday, U.S. Rep. Carol Shae-Porter, D-N.H., sent a letter to the Centers for Medicare and Medicaid Services asking it to address parents of children whose Medicaid eligibility is in limbo or has been denied.  She asked for answers by next Monday.

For now, Robert Clark’s daughter is continuing her gymnastics program, which makes him nervous. “If she falls on her head, we need to be covered,” he said.

The Associated Press contributed to this report.

Kiley Crossland

Kiley is a former WORLD correspondent.

Read more from this writer