There are still about 4.7 million uninsured American children who are eligible for CHIP (Children’s Health Insurance Program) or Medicaid and are not enrolled, says a new report published in the journal Health Affairs. The report estimated about 7.3 million American children were uninsured on an average day in 2008 – of those, 65% of them (4.7 million) were eligible for Medical or CHIP but not enrolled.
According to the report, ten states had participation rates either close to or above 90%. 39% of eligible uninsured children live in California, Florida or Texas, while 61% (2.9 million) live in ten states.
The authors recommend policy reforms and a more concerted and broader effort to get these kids into public medical programs. Income tax data could be used for automatic enrollment, the report adds.
President Barak Obama made health care provision to all American citizens a priority when he signed the landmark healthcare reforms into law last March.
Earlier on this year, Kathleen Sebelius, US Secretary of Health and Human Services issued a challenge:
- The Secretary’s Challenge: Connecting Kids to Coverage is a five‐year campaign that will challenge federal officials, states, governors, mayors, community organizations, faith leaders, and concerned individuals to build on our success and take the next step by finding and enrolling those five million children in Medicaid and CHIP.
The new report has revealed the following information regarding the characteristics of uninsured children in America:
According to our revised coverage estimates, some 7.3 million children were uninsured on an average day in 2008, of whom 4.7 million (65%) were eligible for Medicaid or CHIP but not enrolled. Of these 4.7 million children, 3 million had family incomes below 133% of the federal poverty level, 1.2 million had family incomes of 133-200% of poverty, and 500,000 had incomes above 200% of poverty.
The report estimates that in 2008 there was an overall national rate of 81.8% participation in Medicaid/CHIP (among uninsured eligible children).
Participation rates varied slightly according to geographical area, as can be seen below:
- Northeast 87.7%
- Midwest 85.3%
- West 78.8%
- South 79.8%
The following rates were found in these states:
- Nevada 55.4%
- Utah 66.2%
- District of Columbia 95.4%
- Massachusetts 95.2%
- At least 91% – Hawaii, Maine, Massachusetts, Vermont, and the District of Columbia
- Between 88% and 90% – Arkansas, Kentucky, Louisiana, Michigan, New York, and West Virginia
- Less than 80% – Alaska, Arizona, Colorado, Idaho, Florida, Montana, Nevada, North Dakota, Oregon, South Carolina, Texas, Utah, and Wyoming
The authors add that further research is required to determine the reason for the variations in participation from state to state. Are they due to differences in each state’s characteristics with regard to population density, income per capita, political culture, racial or ethnic composition, and/or access to coverage through their employers?
We also need to find out, the report stresses, how much of the participation variation between states is due to “Specific local policies towards Medicaid/CHIP income eligibility thresholds for both children and their parents, Medicaid and CHIP outreach efforts, and eligibility determination, enrollment and retention.”
As the economy has taken a turn for the worse, the authors expect the number of Medicaid/CHIP eligible children to rise. They say more information on this will be revealed during the fall of 2010, when the new Current Population Survey and American Community Survey is released.
In part of their conclusion, the authors wrote:
Whether states can develop and maintain momentum around increasing Medicaid/CHIP participation among children in the coming years will be critical to determining the extent of progress.
“Who And Where Are The Children Yet To Enroll In Medicaid And The Children’s Health Insurance Program?”
Genevieve M. Kenney, Victoria Lynch, Allison Cook and Samantha Phong
Health Affairs, doi: 10.1377/hlthaff.2010.0747
(Published online September 3, 2010)
Written by Christian Nordqvist