Gov. Steve Beshear is making it easier to enroll in the Kentucky Children's Health Insurance Program, hoping to insure an additional 35,000 children by 2010.
The changes are the right thing to do, the smart thing to do and an economic necessity, Beshear said at a news conference Wednesday at Sandersville Elementary School in Lexington.
"We must recognize that an inquisitive mind begins with a healthy body," he said.
The changes, highlighted by the elimination of a requirement for a face-to-face interview, will help Kentucky cut its expenses for chronic diseases, the governor told the Herald-Leader editorial board Tuesday. Those are the largest part of the state's Medicaid budget. The changes will also reduce the number of emergency room visits, he said.
The move was praised by advocates for health care and education.
"The face-to-face interview posed real barriers for access for families," said Terry Brooks, executive director of Kentucky Youth Advocates.
Sen. Julie Denton, R-Louisville, applauded Beshear's move but questioned how the Cabinet for Health and Family Services, which oversees the program, would prevent fraud without a face-to-face interview.
"There's just been this concern of fraud and the ability to accurately evaluate the validity of their income and their information," said Denton, who chairs the Senate Health and Welfare Committee. Denton also questioned how the cabinet would pay for the increased enrollment.
"We've been told of cuts and things that we can't do because we don't have any money," Denton said.
Those new participants will cost $31.1 million in state money and $81.3 million in federal money over the next two years.
Cabinet Secretary Janie Miller said that finding the state's share within the cabinet's biennial budget of $14.7 billion would be a challenge, but there would never be a "perfect" time to make the changes.
KCHIP provides health, dental and eye insurance to children whose parents make too much to qualify for Medicaid but less than 200 percent of the poverty level, which is $42,400 for a family of four. Almost 53,000 children are enrolled in Kentucky's program. An additional 67,000 children are eligible but not enrolled.
Before 2002, Kentucky had a mail-in application, but the state switched to interviews under Gov. Paul Patton, a Democrat.
That change came during a Medicaid budget shortfall as a cost-cutting measure, said Rep. Kathy Stein, a Democrat who sponsored the original legislation.
"We were enrolling too many children, and we were finding too many Medicaid-eligible folks," Stein said.
Denton, however, said the change came because of concerns about fraud.
Beshear's changes, which will begin in eight weeks, include:
■ Hiring 28 people to process applications and increase outreach.
■ Simplifying the application itself and giving applicants time to provide missing information.
■ Training employees at federally qualified health care centers, free clinics and health departments to assist applicants.
■ Recruiting participants through other programs, such as free and reduced lunch.
■ Sending postcards to the parents of every newborn, telling them about KCHIP.