N.Y. governor threatens to sue after HHS rejects child insurance proposal

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The Department of Health and Human Services (HHS) has rejected a proposal from New York health officials, submitted in May, which would have expanded its insurance program to cover children in families that earn up to four times more than the federal poverty level, according to Modern Healthcare.

The N.Y. proposal sought to allow children in families that earn more than $80,000 per year to be covered under its State Children’s Health Insurance Program (SCHIP).

In August, the Centers for Medicare and Medicaid Services (CMS) released a nationwide directive, indicating it would no longer expand coverage to children from families with incomes 250 percent above the U.S. poverty level, unless a state guarantees 95 percent enrollment of children from families below 200 percent of the poverty level in either SCHIP or CMS. Thus far, no state has reached the 95 percent limitation.

In a letter, the newly-appointed CMS acting administrator, Kerry Weems, states that New York has not demonstrated that its program operates in an “effective and efficient manner” for enrolling a core population of children in families below 200 percent of the poverty level. 

N.Y. Governor Eliot Spitzer lambasted CMS’s decision and, in a written statement, threatened a lawsuit. “New York is prepared to pursue legal action to challenge these rules and step up its efforts in conjunction with our congressional delegation.”

On Sept. 6, Congressman Pete Stark (D-CA) said that some federal lawmakers would like to obtain a legislative reversal to the CMS directive.