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Program Enhancements and Other Budget Adjustments
Managed Risk Medical Insurance Board
The Managed Risk Medical Insurance Board (MRMIB) administers the Healthy Families Program (HFP), the Access for Infants and Mothers (AIM) program, the Major Risk Medical Insurance Program (MRMIP) and the County Health Initiative Matching Fund Program. These four programs provide health care coverage through private health plans to certain populations without health insurance. The MRMIB also develops policy and recommendations on providing health care insurance to the approximately 6.5 million Californians who are estimated to go without health coverage at some point during each year.
The Governor's Budget includes $1.3 billion ($390.4 million General Fund) for MRMIB in 2008-09, a decrease of $2.3 million ($5.6 million General Fund) from the revised 2007-08 budget and $20.4 million ($10.7 million General Fund) below the Budget Act of 2007. This decrease is due primarily to application of the budget balancing reductions.
HEALTHY FAMILIES PROGRAM
The HFP is a subsidized health coverage program for eligible children in families with low- to moderate-income who are ineligible for no-cost Medi-Cal. This program provides low-cost medical, dental and vision coverage to eligible children from birth to age 19. HFP expenditures are projected to decline from revised expenditures of $1.1 billion ($393.6 million General Fund) in 2007-08 to $1.1 billion ($387.8 million General Fund) in 2008-09, a decrease of $5.8 million General Fund, or 1.5 percent. This decline is primarily the result of anticipated implementation of the budget balancing reductions which include a rate reduction for plans, institution of an annual cap on dental benefits, and increases in premiums and co-pays. The increase in premiums and co-pays will vary by income level and are within the percentage of family income allowed under federal law. Program enrollment is projected to grow from 888,450 by year-end 2007-08 to 954,252 by year-end 2008-09, for a total increase of 65,802 children, or 7.4 percent. Figure HHS-09 displays historical caseload and funding growth for the HFP.
The Governor's Budget includes $5.9 million ($2.1 million General Fund) and 2.8 positions for implementation of Chapter 328, Statutes of 2006 (SB 437) that will simplify and accelerate enrollment in the Healthy Families Program as well as allow families to self-certify their income during eligibility redetermination.
ACCESS FOR INFANTS AND MOTHERS PROGRAM
The AIM program provides low-cost, comprehensive health coverage to uninsured pregnant women with family incomes between 200 and 300 percent of the federal poverty level. This coverage extends from the date of enrollment in the program to 60 days postpartum. Eligible children born to AIM mothers are enrolled in the HFP if they have no other insurance coverage. Expenditures for this program are projected to increase from $134.6 million ($60.2 million Perinatal Insurance Fund) in 2007-08 to $153.7 million ($68.8 million Perinatal Insurance Fund) in 2008-09, for a total increase of $19.2 million, or 14.3 percent. This change in total expenditures primarily is due to increased enrollment of women from 13,859 in 2007-08 to 15,836 in 2008-09, an increase of 1,977 women, or 14.3 percent.
MAJOR RISK MEDICAL INSURANCE PROGRAM
The Governor's Budget includes $36 million for MRMIP, which provides health care coverage to medically high-risk individuals and the medically uninsurable who are denied coverage through the individual health insurance market. This funding level reflects a $4 million reduction from the $40 million historical level due to a continuing decline in Proposition 99 revenues. Program enrollment is "capped" at the level of annual funding provided. The program currently provides benefits to a total of 8,043 people, with 65 people on the waiting list as of December 1, 2007.
Chapter 794, Statutes of 2002, required MRMIP participants who had been in the program for 36 months to be disenrolled, but provided for guaranteed-issue coverage offered by health plans in the individual insurance market. This statute sunset on December 31, 2007. Therefore, MRMIB is no longer disenrolling members from MRMIP.
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