Where Would 1.1 Million Kids Be Without the CHIPRA Performance Bonus?

By Martha Heberlein

When CHIP was reauthorized in 2009, the Performance Bonus was designed to reward states for enrolling more Medicaid-eligible children. As my colleague, Jocelyn Guyer, pointed out on Tuesday, the House Energy and Commerce Committee voted last week to eliminate these bonuses.

While this raises questions of whether the Committee supports the intention of connecting the poorest of children to affordable health coverage (as the bonuses were designed to do) perhaps the larger question is where would those newly-covered kids be if states didn’t have the incentive to streamline and simplify their programs to enroll more eligible, uninsured kids?

Data on the bonuses show that in the 23 states that received bonuses in FY 2011, an additional 1.1 million kids were enrolled above expected levels. The most (123,000) can be found in the state of Ohio. While we can’t say that the bonuses fully explain this jump in enrollment, it would certainly be fair to say that they get some of the credit for supporting states in reaching these kids.

As we’ve seen over the years, Medicaid and CHIP have been responsible for driving the uninsured rate of children down to record lows. These bonuses have been an important incentive in making this progress and dismantling them threatens to undercut the great success we’ve seen in Medicaid and CHIP.

FY 2011 PB Enrollment Summary Table FINAL

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