23 States Recognized for Success – Getting More Eligible Children Enrolled in Health Coverage

by Cindy Mann, CMS Deputy Administrator and Director, Center for Medicaid and CHIP Services  

Families across the country are experiencing hard times. The good news is that, despite the challenges States themselves are facing, many States are moving forward to adopt strategies that help get more eligible children enrolled in Medicaid and CHIP and stay enrolled for as long as they qualify.  We are working hard, together with the states, to keep children’s health coverage a high priority.

We are pleased to be able to recognize and support states that are improving their programs and are enrolling more children in health coverage as a result.  Performance Bonuses, authorized by the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), were designed to reward states for making access to health coverage easier for eligible children and signing up more children who qualify.

This year, 23 states qualified for CHIPRA Performance Bonuses totaling nearly $300 million. States were eligible for a bonus if they reached targets for the number of additional children enrolled in Medicaid, and if they took steps to simplify their enrollment and renewal processes, adopting at least five out of eight options.  In addition to providing an incentive for States to make lasting positive changes to their programs, the performance bonuses help offset the added costs of insuring the lowest income children.

Of the states that earned bonuses, seven are new this year: Connecticut, Georgia, Montana, North Carolina, North Dakota, South Carolina, and Virginia. And, many of the states that have received bonuses in the past haven’t stopped improving their programs – five of these states implemented a sixth strategy in an effort to further streamline procedures.

The states awarded performance bonuses for the first time have simplified enrollment and renewal in a variety of ways.  For example:

  • Georgia is using information from the WIC program to make Medicaid enrollment simpler, using the “express lane eligibility” option.
  • Virginia has simplified the eligibility renewal process so that children have an easier time keeping their coverage when it’s time to renew.
  • North Carolina and North Dakota both guarantee eligible children enrollment for a full year, to be sure they get continuous coverage and don’t lose access to care.
  • Montana and Connecticut have adopted the “presumptive eligibility” option, which jump-starts enrollment for children who appear eligible and lets them see a doctor or get a prescription while their full eligibility is being determined.

These and other activities to simplify the process and enroll eligible children are paying off:  New data from the CDC’s  National Center for Health Statistics found that an additional 1.2 million children have gained health insurance coverage since CHIPRA was signed into law in 2009. This increase has been entirely due to greater enrollment in public programs such as Medicaid and CHIP.

Learn more about CHIPRA – and find out what states and communities are doing to get more eligible children covered.


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