By Martha Heberlein
Over the past year, as the nation’s attention was focused on the country’s economic problems and the debate over the passage of broader health care reform, Medicaid and the Children’s Health Insurance Program (CHIP) continued to play their vital role of providing coverage to millions of people who otherwise lack affordable coverage options. In 2010, this role was more pronounced than ever as families, such as the McCrea family of Oregon, lost their jobs and access to employer-based coverage. In increased numbers, they turned to public programs to find affordable coverage options, particularly for their children. Without the stability of Medicaid and CHIP, many more people surely would have become uninsured, adding to the 50 million currently without coverage.
A survey we released today with the Kaiser Commission on Medicaid and the Uninsured shows that families could turn to Medicaid and CHIP because nearly all states (49) “held steady” in 2010. (You may remember this annual survey based on interviews with state officials – it had been conducted by Donna Cohen Ross and her colleagues at the Center on Budget and Policy Priorities before her move to CMS.) This striking stability can be directly attributed to both the temporary Medicaid fiscal relief and the requirement that states maintain their Medicaid and CHIP eligibility rules and enrollment procedures until broader health reform goes into effect.
While just 2 states (Arizona and New Jersey) made changes that rolled back eligibility, a greater number of states implemented targeted expansions and/or improvements to their programs. In fact in 2010, 13 states expanded eligibility for specific groups and 14 states streamlined enrollment and renewal procedures, with the majority of changes focused on children. It’s important to note, however, that while states have made significant progress in expanding coverage for children, eligibility for their parents and other adults continues to lag far behind.
As states continued to adopt technology to modernize their programs, many of these improvements have helped to reduce red tape and paperwork burdens on families while streamlining administrative processes and achieving program efficiencies. For example, 29 states took advantage of the CHIPRA option to verify citizenship through an electronic data match with the Social Security Administration (SSA). Despite these advances, states still have a significant amount of work to be prepared with the online, consumer-friendly enrollment process envisioned under the Affordable Care Act (ACA) in 2014.
As 2011 begins, there are signs of economic recovery, but states will continue to face significant budget pressures due to the downturn, the loss of the enhanced FMAP through American Recovery and Reinvestment Act (ARRA), and the continuing increased need for Medicaid and CHIP. In the face of these challenges, it will be important to focus on sustaining the coverage gains and progress made to date, and continuing to provide an essential lifeline to those children and families who have faced even greater hardships and rely on Medicaid and CHIP for access to health care.
