By Martha Heberlein

Medicaid, and it’s companion program, CHIP have had amazing success in reducing the number of uninsured children over the years. The recent Census numbers highlight this fact – in 2008, the number of uninsured children was at its lowest in 20 years, due in large part to public programs filling in the gaps of declining employer-sponsored coverage. Yet, far too many children remain uninsured, with more than seven in ten of them living in low-income families.

A recent study released by the Urban Institute looked at how many of these uninsured children are eligible for Medicaid or CHIP but not enrolled in coverage. As of 2007, five million uninsured children (64% of all uninsured children) were eligible, with over 90% living in families with incomes below 200% of the FPL.

Why are there so many eligible, but uninsured children? According to a recent survey, 90% of low-income parents with uninsured children said they would enroll their children in Medicaid or CHIP if they were eligible, However, close to half do not think their child qualifies (despite the fact that most children with income less than 200% of the FPL are eligible). Parents often lack accurate information about Medicaid/CHIP programs, don’t know how to get information, and don’t know how to enroll their children. Others find the enrollment process difficult.

Although states have made great strides in improving participation rates over the years, they continue to grapple with how to reach more of these uninsured children, enrolling them in the coverage they are eligible for. There are numerous strategies they can employ: application and renewal processes can be streamlined; states can link with other public programs in which children may be enrolled; and expanded outreach and educational efforts can inform more parents about program details. Millions of uninsured, eligible children stand to gain coverage as a result of such measures.