December 14, 2009

Progress Enrolling Children in Medicaid/CHIP: Who is Left and What are the Prospects for Covering More Children?

This brief was written by Genevieve Kenney, Allison Cook, and Lisa Dubay. The authors write that the Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 gave states additional resources and tools aimed at improving participation in Medicaid and the Children's Health Insurance Program (CHIP). In 2007, five million uninsured children were eligible for Medicaid or CHIP, constituting 64 percent of all uninsured children. Nationwide, over 80 percent of eligible children participated in Medicaid/CHIP, but participation rates, as well as the characteristics of uninsured eligible children, vary dramatically across areas.

Efforts to streamline application and retention processes offer tremendous potential for increasing enrollment among the eligible children who are uninsured. Over 90 percent of low-income parents say they would enroll their uninsured child if he or she was eligible, but around half do not know that their child is eligible, do not know how to apply, or find the application processes difficult. In order to close coverage gaps, states may also need to undertake targeted outreach efforts aimed at teenagers, Hispanics, and other groups of children with lower than average participation rates, provide additional support for community- based application assistance, broaden their outreach strategies to include parents, and address existing barriers in their Medicaid and CHIP application and retention processes.