Delaware Repositions Its Health Approach to the Poor

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November 10, 2014; The News Journal (Wilmington, DE)

As the Affordable Care Act (ACA) enters its second registration period, healthcare exchanges throughout the country are getting ready for a stream of new signups. The State of Delaware has made an additional move, declaring it would close down its Community Healthcare Access Program (CHAP) in February of 2015, stating CHAP has “fulfilled its original purpose to link low-income people to needed health care services.”

CHAP offers discounted medical services for those not eligible for Delaware’s Medicaid program, specifically for those who live below the federal poverty level—those individually making $11,670 a year or less. Those receiving CHAP benefits are typically not eligible for Medicaid, largely because they are undocumented immigrants or make more than Delaware’s income cutoff for Medicaid assistance.

According to the state, the CHAP program “will evolve, change its name, and focus on those ineligible to purchase health insurance or exempt from the federal insurance coverage mandate.” Currently, CHAP is significantly funded by $478,000 of tobacco settlement funds, although the direction of that funding was not mentioned by the state or in other articles.

For some, the move to close CHAP caused concern. The Medical Society of Delaware, which has partnered with the state to provide approximately 600 physicians and specialists willing to assist CHAP enrollees, stated through its president, Dr. Nancy Fan, “Maybe they feel it needs to be refocused. Or maybe we assume we’re providing a greater service than is needed.”

The state sees this decision as one that complies more fully with the ACA. Rita Langraf, Secretary of Delaware’s Department of Health and Social Services, said that CHAP “is charity care, and charity care more or less will be going away based on the mandate that everyone must have health insurance.” Other states may be casting a glance toward Delaware as the country sees more and more ACA registrants.—John Brothers