Connecting Kids to Coverage Challenge to enroll five million uninsured children in Medicaid, CHIP

Sep 4 2010

U.S. Department of Health and Human Services Secretary Kathleen Sebelius and U.S. Department of Education Secretary Arne Duncan today highlighted the Connecting Kids to Coverage Challenge to enroll five million children in Medicaid and CHIP within five years. Since Sebelius announced the Challenge last February, the Centers for Medicare & Medicaid Services (CMS) have built an unprecedented coalition of partners, ranging from state governors to national advocacy organizations, who have stepped up to the challenge to enroll kids and educate families.

“We now have a much better sense of where most uninsured children live, and which communities may need more help.”

Although health coverage is currently available to children in families with incomes up to about $45,000 per year in nearly every state, an estimated five million uninsured children are eligible for Medicaid or CHIP but not enrolled.

"Nothing is more important to our future than the health of our children. No child should have to skip a doctor's appointment or go without the medicine they need because their family can't pay," said Secretary Sebelius. "Despite the great advances that states have made over the years, there are nearly five million uninsured children who are currently eligible for coverage but are not enrolled. I'm challenging everyone, from my state and federal counterparts, to local governments and community-based organizations, to health centers and school districts, to faith-based groups and Indian tribes, to take this conversation about children's coverage to the next level - to find and enroll those five million kids."

"If a child is not healthy, he or she cannot learn," said Secretary Duncan. "The education community has a critical role to play in finding and enrolling eligible children. We're working to involve every member of the school community, including superintendents, principals, teachers, school nurses, and lunch room staff in meeting this achievable challenge."

Secretaries Sebelius and Duncan were joined by Genevieve Kenney of the Urban Institute, whose new report Five Million Eligible But Uninsured: Who and Where Are the Children Yet to Enroll in Medicaid And The Children's Health Insurance Program? was released in Health Affairs on-line today along with a Health Affairs Commentary by Secretary Sebelius, Rising to the Challenge: Tools for Enrolling Eligible Children in Health Coverage.

For years, researchers have struggled to produce accurate estimates on the number of uninsured children in each state. The paper released today by Health Affairs successfully created a new model, using data from The American Community Survey, that enabled researchers to produce meaningful national and state estimates. Some of the key findings include that:

• According to coverage estimates, an estimated 7.3 million children were uninsured on an average day in 2008, of whom 4.7 million (65 percent) were eligible for Medicaid or CHIP but not enrolled
• Participation rates varied across states from 55 percent to 95 percent
• Ten states had participation rates at or above 90 percent
• Thirty-nine percent of eligible uninsured children (1.8 million) live in just three states—California, Texas, and Florida—and 61 percent (2.9 million) are concentrated in ten states.

"This new data will help us to focus our efforts and our grant funding where they are most needed," Sebelius said. "We now have a much better sense of where most uninsured children live, and which communities may need more help."

Together, the Children's Health Insurance Program Reauthorization Act (CHIPRA) and the Affordable Care Act provide $120 million for grants designed to promote enrollment and retention strategies that will increase the prevalence of health coverage.

One of this Administration's key goals is to fulfill the CHIPRA legislation - which the President signed as one of his first acts in office - to ensure that all children who are eligible for Medicaid and CHIP are enrolled in coverage and stay enrolled for as long as they are eligible.

CHIPRA, combined with the American Recovery and Reinvestment Act of 2009 (ARRA) and its recent extension of increased federal Medicaid funding, has given states unprecedented federal support that has enabled them to keep providing essential health services for low-income families through Medicaid during the economic downturn.

To date, 17 national organizations and a number of states have agreed to sign on to the Connecting Kids to Coverage Challenge. These organizations, ranging from the United Way to the American Academy of Pediatrics, represent a broad base of organizations who are working to enroll children in health insurance. The full list includes:

Governor Ted Strickland, Ohio
Governor Ted Kulongoski, Oregon
American Academy of Pediatrics
Center on Budget and Policy Priorities
Families USA
First Focus
March of Dimes
MomsRising
National Academy for State Health Policy
National Association of Children's Hospitals and Related Institutions
National Association of Community Health Centers
National Association of School Nurses
National Council of La Raza
National Covering Kids and Families Network
New England Alliance for Children's Health, Community Catalyst
PICO
The Robert Wood Johnson Foundation
United Way Worldwide
Voices for America's Children

There are a wide range of strategies - like providing 12 months of continuous eligibility for Medicaid or CHIP to reduce the chances of children cycling on and off of coverage and pre-populating renewal forms to make it easier for families to stay enrolled - that are known to help get and keep children insured. HHS will be providing technical assistance as well as targeted grant funding to promote these strategies.