The Children’s Health Insurance Program Reauthorization Act of 2009 created a grant program to improve outreach and enrollment in Medicaid and CHIP. The HEALTHY KIDS and ACCESS Acts marked the third extension of this program earlier this year. To date, this program has provided four rounds of grants to community-based organizations and states as well as three rounds to Tribal organizations to enroll more children.
The program is now authorized through FFY 2027 and an additional $120 million is available for future grant-making in FFYs 2018-2023 and an additional $48 million is available for grants in FFYs 2024-2027. But when will the funding be made available to outreach and enrollment workers?
Unfortunately, there’s reason to believe that the outreach and enrollment grants will not be announced until sometime next year, at least 6 months after the current round of grants expire in June. That’s because the Congressional delay to reauthorize CHIP funding prevented CMS from moving forward with a new round of grants in a timely manner.
For the federal government to ensure that grant dollars are awarded fairly, they must go through an open and transparent process, giving all interested parties an equal opportunity to apply. Once the applications are received, the process for review and approval is similarly rigorous in order to award funding to only the strongest proposals. This process takes a long time.
For example, the last round of general outreach and enrollment grant funding went like this –
- April 2015: Congress passed MACRA, including additional funding for outreach and enrollment grants;
- November 2015: CMS issued a Funding Opportunity Announcement;
- January 2016: Applicants submitted proposals in response to the FOA;
- June 2016: CMS awarded the outreach and enrollment grants for a two-year period.
It’s safe to assume the process will be similar for the new funding but because of the delay in Congressional action, it couldn’t get started until February 2018. That means that funds are not likely to flow to grantees until about April 2019. CMS may be able to issue no-cost extensions to grantees that have not spent the full award amount, allowing current outreach and enrollment efforts to continue past June. But it’s highly unlikely that the money will stretch for an additional 10 months.
We’ve reached historic coverage levels for children in the US but recent events threaten that progress. Congress spent much of last year debating proposals to cut and cap Medicaid and repeal the ACA instead of working on a timely CHIP reauthorization. Meanwhile, the Administration cut navigator funding by 41% and limited special enrollment periods for Marketplace plans. Now outreach and enrollment funding for children will come too late for back to school efforts and open enrollment periods this Fall, interrupting current work and risking lower enrollment overall. Not to mention the news out this week that the Administration would like to rescind $7 billion from CHIP. Taken together, this series of events makes it clear that continuing our nation’s progress in covering all children is not a top priority for policymakers.