Exactly one year after President Obama signed the Children’s Health Insurance Program Reauthorization Act, HHS Secretary Kathleen Sebelius and Agriculture Secretary Tom Vilsack today announced that 2.6 million more children were served by Medicaid or the Children’s Health Insurance Program (CHIP) at some point over the past year and released “The Children’s Health Insurance Program Reauthorization Act One Year Later: Connecting Kids to Coverage,” a comprehensive review of the past year’s accomplishments in finding and enrolling children in health coverage.
Sebelius also highlighted “The Secretary’s Challenge: Connecting Kids to Coverage,” a five-year long campaign that will challenge federal officials, governors, mayors, community organizations, tribal leaders and faith-based organizations to build on this success and enroll the nearly five million uninsured children who are eligible for Medicaid or CHIP but are not enrolled.
As part of the Secretary’s challenge, Vilsack and Sebelius announced plans to work with state Supplemental Nutrition Assistance Programs (SNAP, formerly the food stamp program), to encourage them to work with their state’s Medicaid and CHIP programs to share data and identify uninsured children who are potentially eligible for coverage through Medicaid or CHIP. Leaders from the Departments of Agriculture and HHS will provide guidance to state officials on how to better share data and reach families in need.
“One of President Obama’s first actions as President has proven to be a tremendous success,” said Sebelius. “Now we must build on our accomplishments. Today, I am calling on leaders across the country – from federal, state and local officials to private sector leaders – to join our effort to insure more children. We all have a stake in America’s children and together, we will ensure millions more children get the care they need.”
“We must make every effort to break down barriers so that the American people can better access the federal benefits that they qualify for,” said Vilsack. “The partnership we are announcing today will bring new cooperation between HHS and USDA so that families who qualify for food assistance can better access affordable health insurance for their children.”
States were able to increase enrollment in the two programs in part because of boosts in federal support provided by the American Recovery and Reinvestment Act (ARRA). ARRA temporarily increased federal matching funds for state Medicaid programs during the recession and the President’s budget proposes extending this increase for an additional six months.
In addition to providing new funds for covering children, and offering states new options to improve children’s coverage, CHIPRA included $100 million in federal funds dedicated to outreach and enrollment efforts. A portion of those outreach funds – $10 million —were targeted specifically to American Indian and Alaska Native populations. These grant awards to Indian health providers will be announced in April. Last year, HHS awarded $40 million in outreach grants to states and community-based organizations and nearly $73 million to nine states that simplified their programs and met Medicaid enrollment targets for children.
While Medicaid and CHIP have helped bring the rate of uninsured children to the lowest level in more than two decades, an estimated five million uninsured children are thought to be eligible for one of these programs yet not covered.
The Secretary’s Challenge: Connecting Kids to Coverage will support efforts to reach more children by providing leaders with critical information and support as they work to insure more children in their communities and by closely monitoring progress.
“State policymakers have demonstrated their commitment to improving children’s health, even as they face economic challenges,” said Cindy Mann, director of the Center for Medicaid and State Operations within the Centers for Medicare & Medicaid Services (CMS). “Now, we will work with leaders at every level to help cover more children.”
More information about CHIP can be found at www.insurekidsnow.gov.
A fact sheet providing more information on CHIPRA is included below.
Fact Sheet: Children’s Health Insurance Program Reauthorization Act (CHIPRA)
New State Strategies to Boost Enrollment
Given new flexibility under CHIPRA, states have adopted several new strategies to ease enrollment. Since CHIPRA was enacted on February 4, 2009, states have sought CMS approval for the following program improvements:
* 17 states have submitted plans to CMS to streamline their enrollment and renewal processes;
* Three of these states have received approval for the new Express Lane Eligibility option in Medicaid and/or CHIP. Express Lane eligibility allows states to enroll children into one of the programs based on information obtained through other state programs and data bases;
* 15 states have expanded income eligibility levels in their CHIP and/or Medicaid programs;
* 19 states have lifted the five-year waiting period for eligible children and/or pregnant women who are lawfully residing in the United States; and,
* All 50 states set up data agreements with the Social Security Administration to verify citizenship for purposes of Medicaid and CHIP eligibility.
Funding enhancements have led all but two states to covering children in families earning at least 200 percent of the federal poverty level, or $48,100 for a family of four in 2009. Families at this income level contribute to the cost of coverage through monthly premiums and other out-of-pocket expenses.
Enhanced Emphasis on Quality of Care
CHIPRA also provided an increased emphasis on assuring quality of care for children. In December 2009, HHS released a proposed core set of child health quality measures designed to assist states and health care providers in monitoring access to care and health outcomes for children. In addition, CHIPRA approved funding for a series of demonstration projects designed to establish and evaluate a national quality system for children's health care. In the fall of 2009, CMS issued a request for project proposals covering areas such as:
* Promotion of the use of Health Information Technology for the delivery of care for children covered by Medicaid/CHIP;
* Evaluation of provider-based models that improve the delivery of Medicaid/CHIP children's health care services;
* Demonstration of the impact of the model Electronic Health Records format for children on improving pediatric health, and pediatric health care quality, as well as reducing health care costs.
Proposals were due to CMS on January 8, 2010 and CMS is in the process of reviewing 24 applications involving 31 states (several of the applications were multi-state proposals). Ten demonstration awards are scheduled to be announced on February 22, 2010. The full report and more information about CHIP can be found at www.insurekidsnow.gov.
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