By Jocelyn Guyer

In my house, I have a general policy for my three boys that they can’t use the words “stupid” and “dumb” unless they are truly warranted (e.g., you can’t call your brother stupid for forgetting the napkins when setting the table, but, I let it go when they decided that Anthony Weiner had acted stupidly).  Still, when the Energy and Commerce Committee voted last week to cancel performance bonus payments to states that enroll more low-income children in health care coverage, I had a hard time restraining myself from using this type of harsh language.

Created by the Children’s Health Insurance Program Reauthorization Act (CHIPRA) of 2009, the bonuses reward states for demonstrating concrete success in enrolling low-income uninsured children in Medicaid.  To qualify, states must adopt one of a series of measures that simplify enrollment in coverage and reach enrollment targets.  To date, the bonuses have worked exactly as intended – rewarding states for tackling the challenge of making sure that the lowest-income children in this country are connected to coverage.  While the bonuses only modestly offset the cost of successfully enrolling more eligible children in Medicaid, they have had an “outsized” impact by inspiring states to make it easier for eligible children to be enrolled in affordable health plans.  States across the country seem to appreciate the additional fiscal help, modest thought it is, as well as the all-too-rare public recognition of their hard work and innovation.  Indeed, states from Washington and New Mexico to Louisiana and New Jersey have enjoyed the benefits of the bonuses (See map below).  Last year, 23 states across the country received a little over $296 million in bonuses.