Utah has made strides in enrolling eligible children in the Children's Health Insurance Program, and the federal government is taking note.
Letting kids covered and keeping them covered means healthier kids and families and helps our state spend scarce health dollars wisely. —Lincoln Nehring

SALT LAKE CITY — For the second time since 2009, Utah collected a bonus for enrolling eligible children in health care coverage.

The U.S. Centers for Medicare and Medicaid is giving Utah more than $5.3 million this year as part of the Children's Health Insurance Program Reauthorization Act, which awards states based on enrollment and retention of eligible kids in government programs.

Despite advances in coverage — an increase of 10 percent — another 10 percent of Utah kids remain uninsured. Utah also continues to have high rates of uninsured children, placing 15th in the country.

"Getting kids covered and keeping them covered means healthier kids and families and helps our state spend scarce health dollars wisely," said Lincoln Nehring, senior health policy analyst at Voices for Utah Children, an advocacy group for Utah kids.

Nehring credits Utah leadership for the progress but said more could be done.

The majority of Utah's 90,700 uninsured children are eligible for Medicaid or the Children's Health Insurance Program, and Utah is 50th in the nation for its enrollment of kids in the programs.

Nehring said Utah's programs could make changes that would help enroll and keep more kids enrolled, including moving to a 12-month continuous eligibility so families must sign up just once each year, as well as development of a system that would connect families to various insurance options based on eligibility. Another step would involve expanding Medicaid to more parents, as data show such a move results in insuring more children.

Utah leaders have yet to make a decision on Medicaid expansion, as it regards to the Affordable Care Act, but in-depth discussion is expected at the upcoming session of the Utah Legislature.

The performance awards have been available for five years, and Utah collected its first CHIPRA bonus (about $10.2 million) last year. This is the final year the federal government is offering the stimulus.

In Utah, 74.3 percent of eligible children are enrolled in available insurance programs, whereas the national average is nearly 85 percent, according to CMS, an office of the Department of Health and Human Services.

The legislation that made the bonuses possible asks states to simplify and streamline the enrollment process with a number of provisions and increase enrollment year over year.

Utah has eliminated its in-person interview requirement, which allows more Utahns from rural areas of the state to more easily apply, and has coordinated various application efforts that make it easier for more Utahns to enroll and maintain their enrollment.

The federal agency, which announced more than $307 million in bonuses to 23 states Monday, said the simplifications afforded by the act "have led to improved coverage for children and have helped lay the groundwork for outreach efforts aimed at enrolling people now eligible for coverage under the Affordable Care Act."

"By adopting the program features needed to earn a CHIPRA bonus, states have implemented sustainable improvements to their programs," CMS states. "They have helped eligible children gain and retain access to health insurance and also have helped achieve administrative efficiencies."

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Recent U.S. Census data show that uninsured rates for children declined from 8.6 percent in 2009 to 7.5 percent in 2011. In addition, an analysis by the Urban Institute found that participation rates in Medicaid and CHIP have continued to improve over time. In 2011, 87.2 percent of eligible children were enrolled, a 5.5 percentage point increase from 81.7 percent in 2008.

The bonuses help states by offsetting the costs of insuring the lowest-income children and encouraging them to adopt sustainable improvements in their children’s health coverage programs. Such improvements include eliminating face-to-face interview requirements so applications can be filed online or through the mail, using electronic data-matching to cut down on paperwork, and making it easier to renew, thereby minimizing disruptions in coverage and necessary treatment.


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