Sacramento Head Start Alumni Association

ADVOCATES' CORNER: TRANSITIONAL MEDICAID

Sep 10, 2003

Child Health Information Project
Children's Defense Fund
September 8, 2003
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SPECIAL EDITION ISSUE

*ADVOCATES' CORNER: TRANSITIONAL MEDICAID
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ADVOCATES' CORNER

Please contact your senator to insist that transitional Medicaid be
extended and strengthened as part of TANF reauthorization.

Transitional Medicaid allows families who would otherwise lose Medicaid
coverage due to higher earnings, including many families leaving
welfare
for work, to keep their health insurance coverage for up to one year.
This extended Medicaid coverage is critical, because parents who leave
TANF (cash welfare) for work rarely find jobs with employer-provided
health coverage. Transitional Medicaid promotes and supports work, and
as a result has traditionally enjoyed strong bipartisan backing.

The TANF reauthorization legislation scheduled for a vote in the Senate
Finance Committee this week, however, does not include the provisions
in
last year's version of the bill that would have enhanced transitional
Medicaid (also known as TMA). These provisions would, for example,
give
states the option to provide 12 months of continuous transitional
coverage through elimination of burdensome Federally-mandated reporting
requirements. States would also be allowed to provide an additional 12
months of transitional coverage, for a total of 24 months of coverage.
Many of these transitional Medicaid provisions were included in the
Administration's FY 2004 budget.

Congress should take advantage of this opportunity to extend
transitional Medicaid coverage to more parents who need this coverage
to
take and keep jobs. Poor women tend to have more health problems and
consequently greater health care needs than women in general.

Please call, e-mail or fax your senator to insist that transitional
Medicaid be both extended and improved as part of TANF reauthorization.
Below please find a sample letter. It is particularly important to
contact the following members of the Senate Finance Committee:

Charles E. Grassley (IA), Chairman (202) 224-3744 [224-4515 for
non-Iowa residents]
Orrin G. Hatch (UT) (202) 224-5251
Don Nickles (OK) (202) 224-5754
Trent Lott (MS) (202) 224-6253
Olympia J. Snowe (ME) (202) 224-5344
Jon L. Kyl (AZ) (202) 224-4521
Craig Thomas (WY) (202) 224-6441
Rick Santorum (PA) (202) 224-6324
Bill Frist (TN) (202) 224-3344
Gordon Smith (OR) (202) 224-3753
Jim Bunning (KY) (202) 224-4343

Their e-mail addresses can be found at www.senate.gov. If your
senators are not on the Finance Committee, please ask them to express
to
Senator Grassley their support for extending and enhancing transitional
Medicaid. Thank you for your help.

**SAMPLE LETTER**

Dear Senator,

I urge you to ensure that the TANF reauthorization legislation
considered by the Senate this year includes the provisions in last
year's WORK Act to extend and enhance transitional Medicaid.

As you know, transitional Medicaid allows families who would otherwise
lose Medicaid coverage due to higher earnings, including many families
leaving TANF for work, to keep their health insurance coverage for up
to
one year. This extended Medicaid coverage is critical, because parents
who leave welfare for work rarely find jobs with employer-provided
health coverage. Transitional Medicaid promotes and supports work,
which is why the program has traditionally enjoyed overwhelming
bipartisan backing.

Many parents who leave TANF for work find jobs paying less than $7 per
hour, and only half of all workers in these jobs have employer-provided
health insurance. The employers that do offer health insurance to
lower-wage workers often limit it to longer-term employees. As a
result, parents leaving welfare are even less likely than lower-wage
workers as a whole to have health coverage through an employer. The
Urban Institute found that only one in five parents who had left TANF
had coverage through an employer during the first year after exit.
Employer-provided coverage was considerably higher for those parents
who
had left welfare more than a year earlier, which demonstrates the
importance of transitional Medicaid coverage. ("Transitional Medical
Assistance and Welfare Reform," testimony of Cindy Mann, Kaiser
Commission on Medicaid and the Uninsured).

The TANF reauthorization legislation reported by the Senate Finance
Committee last year would have extended and improved transitional
Medicaid (TMA). The WORK Act included provisions to simplify and
enhance TMA by giving states the option to provide 12 months of
continuous transitional coverage through elimination of
Federally-mandated reporting requirements that can be burdensome for
both families and states. The bill would have also allowed states to
provide an additional 12 months of transitional coverage, for a total
of
24 months of coverage, and to further simplify TMA. Many of these
transitional Medicaid provisions were included in the Administration's
FY 2004 budget.

It is essential that TANF reauthorization legislation considered by the
Senate this year include the transitional Medicaid provisions in last
year's WORK Act, which would help families move from welfare to
employment and remain employed. If the Senate is unable to reauthorize
TANF this year, the TMA extension and enhancement should be moved
independently. Thank you for your help.

Sincerely,