States receive millions for boosting Medicaid enrollment

The Obama administration has awarded nearly $300 million in bonuses to states that have identified and enrolled eligible children in public health coverage programs like Medicaid and the Children's Health Insurance Program. The bonuses, provided to 23 states, are designed to make it easier for children in low-income families to access needed health care.

They are funded under the Children's Health Insurance Program Reauthorization Act of 2009 and target states that make it easier for children to be enrolled in Medicaid or the CHIP program. Health and Human Services Secretary Kathleen Sebelius said Wednesday that 1.2 million more children now have coverage than did when the act was reauthorized.

A statement from HHS said that the bonuses "help offset the costs states incur when they enroll lower-income children in Medicaid. By ensuring that states streamline their enrollment and renewal procedures, the bonuses also give states the incentive to adopt long-term improvements in their children's health insurance programs."

Maryland and Virginia got the biggest grants, at $28.3 million and $26.7 million. The smallest of the awards, $1.3 million, went to Idaho. The states receiving the awards were Alabama, Alaska, Colorado, Connecticut, Georgia, Idaho, Illinois, Iowa, Kansas, Louisiana, Maryland, Michigan, Montana, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, South Carolina, Virginia, Washington and Wisconsin.

"More children now have the advantages health coverage provides," Sebelius said. "And parents now have the security of knowing their children can get the health care they need without worrying that an illness could leave them with a lifetime of medical bills."

To get the performance bonus, each state had to adopt at least five of eight specific program features and document "significant increases" in Medicaid enrollment of children.

According to an ASPE issues brief, the increased enrollment has occurred at a time when health coverage for adults has decreased from 83 percent to 80 percent. "Given these opposite trends," it says, "it is clear that expanded insurance options for children have been the difference."

The number of young adults with insurance has also increased by 2.5 million with the provision in the Affordable Care Act that young adults can remain on their parents' insurance plans until age 26, the report said. ASPE refers to the office of the assistant secretary for planning and evaluation.

A Centers for Medicare and Medicaid Services blog noted some of the different approaches states have taken to the challenge of making it easier to enroll and stay covered. It said Georgia uses information from its Women, Infants and Children program to simplify enrollment, "using the express lane eligibility option," while Virginia has made the renewal process easier. Both North Carolina and North Dakota guarantee eligible children enrollment for the entire year once they qualify.

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