Published March 2011
Percent of Eligible Children Enrolled in Medicaid and the Children's Health Insurance Program (CHIP), 2008
Source: G. M. Kenney, V. Lynch, A. Cook and S. Phong, “Who and Where Are the Children yet to Enroll in Medicaid and the Children’s Health Insurance Program?” Health Affairs 29, no. 10 (October 2010): 1920-1929.
Health Insurance Coverage of Children Ages Birth to 18 in the United States, 2009
Uninsured Children by Poverty Status, Age and Race and Hispanic Origin, 2009
|Source: Kaiser Family Foundation, statehealthfacts.org
Source: C. DeNavas-Walt, B. D. Proctor and J. C. Smith, Income, Poverty, and Health Insurance Coverage in the United States: 2009. U.S. Census Bureau, Current Population Reports (Washington, D.C., 2010).
• In 2009, 8.3 million children under age 18 were uninsured.
• Nearly three-quarters of uninsured children live in families with incomes below 200 percent of the federal poverty guidelines ($44,700* for a family of four in 2011).
• Most uninsured children have at least one parent who is employed full-time.
State Strategies for Outreach, Enrollment and Retention
The U.S. Department of Health and Human Services’ secretary issued a challenge to states to enroll an additional 5 million children in Medicaid and the Children’s Health Insurance Program (CHIP) over five years. States can implement a variety of strategies to increase Medicaid and CHIP participation rates. Between fiscal years 2009 and 2015, $126 million has been designated for grants for states and other entities for outreach and enrollment activities. The Children’s Health Insurance Program Reauthorization Act of 2009 authorizes performance bonus payments to states if they achieve certain target enrollment rates and implement at least five of the following strategies to enroll children in Medicaid and CHIP:
• Adopt 12-month continuous eligibility,
• Eliminate asset tests,
• Eliminate in-person interview requirements for application and renewal,
• Adopt presumptive eligibility while final eligibility status is pending,
• Offer “Express Lane Eligibility” based on eligibility for other government programs,
• Use administrative renewals,
• Use a joint application and a single verification process for separate Medicaid and CHIP programs, or
• Offer a premium assistance option.
Sources: National Conference of State Legislatures, 2011; Kaiser Family Foundation, 2011.
* $55,880 for a family of four in Alaska; $51,420 for a family of four in Hawaii.
Children's Health Insurance Program (CHIP) Overview
NCSL, State Legislatures magazine, June 2009
Secretaries Sebelius and Duncan announce national coalition to enroll uninsured kids in health care
U.S. Department of Health and Human Services, Press Release, September 3, 2010
States get bonuses for boosting enrollment for uninsured children in Medicaid
U.S. Department of Health and Human Services, Press Release, December 27, 2010
Health Insurance Coverage of Children Under Age 19: 2008 and 2009
American Community Survey Briefs
U.S. Census Bureau, September 2010
Outreach and Enrollment Grants
Centers for Medicare and Medicaid Services webpage
An Overview of the CHIPRA Outreach and Enrollment Grants
Center for Children and Families, Georgetown University Health Policy Institute, July 2009
Medicaid & CHIP: Enrollment and Outreach
Kaiser Family Foundation
Robert Wood Johnson Foundation
Who and Where are the Children yet to Enroll in Medicaid and the Children’s Health Insurance Program?
Health Affairs 29, no. 10 (October 2010): 1920-1929
Enrolling More Kids in Medicaid and CHIP
Health Affairs, Health Policy Brief, January 27, 2011
This webpage was adapted from an NCSL postcard published in March 2011.