Stuff to know.

Ohio has won its long-running fight with federal regulators to offer health care to another 31,000 uninsured children.

Now the question is: Can the state afford its share of the bill?

A spokesman for Gov. Ted Strickland's administration said the budget crisis will weigh heavy in determining whether the state will be able to expand the popular Children's Health Insurance Program. A decision is expected early this year.

Had the expansion been in effect in the current fiscal year, the state's 30 percent share would have been about $10.3 million, a state official said. The federal government pays 70 percent.

Children's advocates weren't letting the uncertainty dampen their celebration of Ohio getting the go-ahead to expand its program.

"This couldn't come at a better time for Ohio's working families," said Amy Swanson, executive director for Voices for Ohio Children.
"For a lot of families, this will be their ticket out of bankruptcy. One visit to the emergency room can break a family," she said. Swanson noted that as the economy flounders, more employers are simply offering health insurance to their employee, and not extending coverage to their families, leaving many children uninsured.

At the urging of the governor, Ohio lawmakers in June 2007 approved expanding eligibility in the children's health-insurance program. Because the federal government pays most of the tab, the plan was also subject to approval by the Bush administration, which consistently fought efforts by Congress to increase federal aid to state programs.

Federal regulators rejected Ohio's request in December 2007. The state, however, appealed that decision and resubmitted the request.

The Bush administration, in its waning days, failed to act on the request within the required 90 days. When that clock ran out last month, the application was automatically approved.

Mary Kahn, spokeswoman for the Centers for Medicare and Medicaid Services, said such approvals by inaction are not common but do happen.

With the regulatory roadblocks removed, Ohio can move ahead with its plan to offer health care to uninsured children living in households earning up to 300 percent of the federal poverty level. That's $52,800 a year for a family of three.

Ohio's program currently serves about 150,000 children with eligibility capped at 200 percent of poverty. An estimated 20,000 of the 31,000 higher-income children who would be eligible for coverage would enroll in the program.

"The decision on whether to do this will be made within the context of the upcoming budget," said Strickland spokesman Keith Dailey.

Officials project that the two-year budget starting July 1 faces a $7.3 billion deficit.

The expansion, Swanson said, would make health care available to all but about 20,000 higher-income, uninsured Ohio children.

"This is a very significant expansion for Ohio, certainly one of the more significant expansions we've seen from any state," said Dave Lemmon, spokesman for Families USA, a Washington-based nonprofit health-care advocacy group.

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