Medicaid and CHIP have been instrumental in driving the uninsured rate for children to all time low. In recent years, however, this progress has stalled nationally and even reversed in some states. It’s no secret that sustained outreach is key to success in connecting uninsured kids to coverage. So we were particularly pleased that Congress earmarked another $40 million for outreach and enrollment activities when it extended funding for CHIP in April. We put our heads together at CCF to come up with some recommendations for CMS on how best to target the next round of outreach and enrollment grants.

• Target states with low child participation rates in Medicaid and CHIP. Cycle III Outreach and Enrollment Grants targeted states with the highest number of uninsured. However, another more precise way of targeting eligible but not enrolled children is to award grants in states with the lowest Medicaid and CHIP participation rates.

• Prioritize grants to community-based organizations. CBOs are key partners in connecting children to coverage, but few states fund community-based outreach and enrollment activities. Notably, CBOs can be extremely effective in reaching persistently hard-to-reach populations.

• Give weight to navigator organizations. Given the alignment of eligibility across the continuum of affordable insurance programs, there can be synergy and economies of scale in awarding outreach and enrollment grants to navigator organizations already doing much of this work.

• Continue to focus attention on retention. States continue to be challenged in achieving the ACA’s goal of highly automated Medicaid and CHIP renewals. As a result, there is the potential to lose the gains we have made in covering children. Efforts to improve retention rates and eliminate churn should be supported.

• Encourage states to set up certified application counselor programs for Medicaid and CHIP. Consumer assisters are making an important difference in connecting particularly hard-to-reach consumers to coverage. States that embrace Medicaid and CHIP CAC programs are likely to extend their reach and effectiveness in enrolling eligible individuals. 

• Support state technology investments through 90-10 funding, not limited funds intended for outreach and enrollment. States have access to a generous 90 percent federal match for MAGI-based eligibility and enrollment systems that meet federal standards. As such, the outreach and enrollment grants should be invested in community-based activities not state technology.

It’s not clear when the solicitation for the next round of grants will be announced, but community-based organizations should be thinking about projects that will regain the momentum in enrolling the 3.7 million uninsured but eligible children in Medicaid or CHIP.