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Program Enhancements and Other 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 develops policy and recommendations on providing health care insurance to the approximately 6.6 million Californians who are estimated to go without health coverage at some point each year.
The Governor's Budget includes $1.3 billion ($394.7 million General Fund) for MRMIB, an increase of $82.5 million ($32.7 million General Fund) above the revised 2006-07 budget and $87.8 million ($24.4 million General Fund) above the Budget Act of 2006. This increase is due primarily to enrollment growth in the HFP.
HEALTHY FAMILIES PROGRAM
The HFP is a subsidized health coverage program for children in families with low- to moderate-income who are ineligible for no-cost Medi-Cal. This program, established in 1998, provides low-cost medical, dental and vision coverage to eligible children from birth to age 19. HFP expenditures are projected to grow from revised expenditures of $1.0 billion ($360 million General Fund) in 2006-07 to $1.1 billion ($392 million General Fund) in 2007-08, an increase of $32 million General Fund, or 8.9 percent. This increase is primarily the result of enrollment that is projected to grow from 841,700 by year-end 2006-07 to 915,600 in 2007-08 for a total increase of 73,900 children, or 8.8 percent. Figure HHS-08 displays historical caseload and funding growth for the HFP.
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 pregnancy to 60 days postpartum. Children born to AIM mothers are automatically enrolled in the HFP. Expenditures for this program are projected to increase from $127.5 million ($60.4 million Perinatal Insurance Fund) in 2006-07 to $138.7 million ($60.7 million Perinatal Insurance Fund) in 2007-08, for a total increase of $11.2 million, or 8.8 percent. This change in total expenditures primarily is due to increased enrollment of women from 12,097 in 2006-07 to 13,912 in 2007-08, an increase of 1,815 women, or 15 percent. Costs for 2006-07 reflect $7.2 million in Proposition 99 funds needed to repay the federal government for its share of program subscriber revenues that were not offset against claims previously submitted for 2004-05 and 2005-06.
MAJOR RISK MEDICAL INSURANCE PROGRAM
The Governor's Budget includes $40 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. Program enrollment is "capped" at the level of annual funding provided. The program currently provides benefits to a total of 8,700 people, with 80 people on the waiting list primarily serving their required post-enrollment waiting period. Pursuant to Chapter 794, Statutes of 2002, subscribers who have been in the program for 36 months are transitioned into guaranteed-issue coverage offered by health plans in the individual insurance market.
The Governor's Budget redirects $0.2 million from direct services to fund 2 positions to expand the level of accountability and oversight of the administrative vendor, upgrade and streamline existing administrative vendor contract functions, and develop financial and data management improvements to ensure better fiscal accountability and the maximization of available funding.
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