Despite the economic downturn, the number of uninsured children eligible for Medicaid and CHIP programs fell to 4.4 million in 2010, a 10 percent decrease from the 4.9 million who were uninsured in 2008, according to an analysis of government data released recently by the Robert Wood Johnson Foundation.
In all, the government figures show that 86 percent of all children not eligible for private insurance are enrolled in the public insurance program that are intended to provide insurance for children and enable them to get needed healthcare. Urban Institute researchers – who prepared the report for RWJF – pointed to a handful of reasons for the improvement in insurance rates among kids, including expanding eligibility for the program, improved enrollment and retention systems and implementation of a number of policy options provided under the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009.
"These findings suggest that efforts to make Medicaid and CHIP enrollment and retention systems for children more coordinated and streamlined have paid off – the programs are successfully enrolling many uninsured children," said Genevieve Kenney, the lead author and a senior fellow at the Urban Institute, in a press release announcing the results. "As states consider expanding Medicaid to more low-income adults under health reform, this research suggests they may be able to better reach eligible adults if they adopt the strategies that are working for children."
Some of the changes states used under CHIPRA to increase enrollment included tapping newly available federal funds to help pay for outreach efforts and express lane eligibility policies, and working in concert with the Supplemental Nutrition Assistance Program, school lunch programs, the tax system and other program to better identify those who might be eligible for CHIP or Medicaid.
In terms of streamlining the enrollment system, the researchers found that 44 states had taken advantage of the option under CHIPRA to verify citizenship using electronic data matches in Social Security Administration data.
While the news is good for children, uninsurance among their parents, who aren't eligible for the same programs, remains a problem. While the median Medicaid and CHIP program to insure children allowed for the children to be eligible for benefits if they are living in a household earning 250 percent of the federal poverty limit (FPL) – or about $57,625 annually for a family of four – only 18 states currently have a program that insures adults above the FPL.
Thirty-three states have coverage limits for adults below the FPL and another 17 of those provide Medicaid coverage only to those earning less than 50 percent of FPL.
State-by-state analysis showed that 14 states had participation rates higher than 90 percent (Arkansas, Connecticut, Delaware, the District of Columbia, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, New York, Tennessee, Vermont and West Virginia). Only six states had participation rates lower than 80 percent (Colorado, Idaho, Montana, Nevada, Texas and Utah).
The District of Columbia ranked first among with a children's Medicaid and CHIP participation rate of 97.2 percent while Nevada's participation rate of 67.3 percent was substantially below the two next lowest states – Montana and Utah – each at 74.3 percent.