Projects CHIP Medicaid

2019 Medicaid and CHIP Snapshot Data Sources

March 20, 2019

Name of CHIP Program              

  • Kaiser Family Foundation, CHIP Program Name and Type, State Health Facts (as of May 1, 2015).
  • Please note that effective 2013 the former California CHIP program,California Healthy Families Program has been converted into Medi-Cal.

Type of CHIP Program

Number of Children Enrolled in Medicaid/CHIP and Percent of Medicaid/CHIP Enrollees that are Children

Georgetown CCF analysis of monthly CMS Medicaid & CHIP Enrollment reports for 48 states. States report data for each calendar month. Coverage is a point-in-time estimate of unduplicated number of children enrolled in Medicaid/CHIP who are receiving comprehensive benefits. Child is defined on a state-by-state basis. CHIP covers pregnant women in some states so there may be some adults included in the total number of enrollees. Forty-eight states reported monthly enrollment data in December 2018. Three states (Arizona, District of Columbia, and Tennessee) had no available data.

For the state of Arizona, we use the most recent enrollment data made available by the state. Because the state provides enrollment data on a quarterly basis, we estimate enrollment using data from January 2019.

For the District of Columbia, we use enrollment data made available by the state. Because the District of Columbia has not updated enrollment data for December 2018, we estimate enrollment using data from November 2018.

For Tennessee, we use enrollment data made available by the state. Because Tennessee does not report CoverKids enrollment data for 2017, we estimate the enrollment by using CoverKids and TennCare enrollment data from January 2019.

Sources of Children’s Coverage

Kaiser Family Foundation estimates based on the Census Bureau’s American Community Survey, 2017. Total may not sum to 100 percent due to rounding.

Children in Foster Care with Medicaid/CHIP                

Urban Institute analysis of Medicaid Statistical Information System (MSIS) data. In 2001, states provided Medicaid coverage to approximately 870,000 foster care children for $3.8 billion. “All foster children for whom states receive federal reimbursement for foster care expenses (under title IV-E of the Social Security Act) are categorically eligible for Medicaid. States have the option to extend Medicaid benefits to non-IV-E eligible foster children, and all states do. In addition, children receiving federally reimbursed adoption subsidies are categorically eligible for Medicaid. All states, but one, have also chosen to cover adopted children supported by state-funded subsidies in their Medicaid programs. Thus, virtually all children in foster care and in adoptive placements are eligible for Medicaid.”

Low-Income Children with Medicaid/CHIP

Georgetown CCF analysis of single-year estimates of summary data from the 2017 American Community Survey (ACS) via Fact Finder Table B27016. Children are defined as those under the age of 19. Data on sources of health insurance coverage are point-in-time estimates that convey whether a person has coverage at the time of the survey.

Low-income is defined as children under 138 percent of the Census Poverty Threshold (CPT). Data on poverty levels include only those individuals for whom the poverty status can be determined for the last year. The Census determines an individual’s poverty status by comparing that person’s income in the last 12 months to poverty thresholds that account for family size and composition, as well as various types of income. Coverage includes Medicaid Means-Tested only which includes children with Medicaid/CHIP alone and excludes children with Medicaid/CHIP in combination with another health coverage source. Of note, the federal poverty levels used by HHS in establishing eligibility are slightly different from the CPT. In 2017, 138% of the CPT for a family three was $19,515 compared to the 2017 FPL of $28,120 for a family of three.

Births Financed by Medicaid

For 50 states (including D.C.), the percent of newborns in low-income families with Medicaid/CHIP is provided by the 2017 Kaiser Family Foundation Medicaid Budget Survey, which asked states to report the share of births financed by Medicaid in the most recent 12-month period for which data were available. States reported data for different years that ranged from 2010-2016. Additional information about the methodology is provided in Implementing Coverage and Payment Initiatives: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2016 and 2017.

For Hawaii and the United States, data on percent of births financed by Medicaid is provided by a study done by the Jacobs Institute of Women’s Health at the George Washington University and March of Dimes. States reported data for 2010.

Children with Special Health Care Needs with Public Coverage and a Combination of Public and Private Coverage       

Georgetown CCF analysis of summary data from the 2017 National Survey of Children’s Health. Public health insurance coverage includes Medicaid and CHIP. We also include children with both public coverage and a source of private coverage. When children have both private and public coverage, the private insurance is primary. Having dual coverage is particularly important for these children because private coverage alone may not provide all of the care they need.

The National Survey of Children’s Health defines children with special health care needs (CSHCN) using a screener and definition created by the Maternal and Child Health Bureau. The CSHCN Screener asks whether a child has a medical, behavioral, or other health condition and, if so, whether that health condition has lasted or is expected to last for 12 months or longer. Additional detail about the methodology is provided by the Data Resource Center for Child & Adolescent Health.

Young Children with Medicaid/CHIP

Georgetown CCF analysis of single-year estimates of summary data from the 2017 American Community Survey (ACS) via Fact Finder Table B27003. Young is defined as children under six years old. Coverage includes children with public coverage only (Medicaid/CHIP alone or in combination with another health coverage source).

Medicaid and CHIP Financing

 

Increase in the Number of Uninsured Children (2016-2017)

Georgetown CCF analysis of the change in the number of uninsured children between 2016 and 2017 based on single-year estimates of summary data from the 2016 and 2017 American Community Surveys (ACS). The ACS reported an increase in the national uninsured rate for children from 4.7% in 2016 to 5.0% in 2017, with an increase of 276,000 uninsured children between the two years. The increase was largely due to statistically significant increases in the uninsured rate in nine states. This was the first increase in the uninsured rate in more than a decade. There was no statistically significant change in the uninsured rate in other states but the progress in covering children stalled. Children are defined as those under the age of 19. Data on sources of health insurance coverage convey whether a person has coverage at the time of the survey. The ACS is administered throughout the calendar year.

Decline in Medicaid and CHIP Enrollment in 2018

Georgetown CCF analysis of CMS Medicaid & CHIP Enrollment monthly enrollment reports for December 2017 to December 2018. Child enrollment in Medicaid/CHIP dropped by approximately 840,000 nationwide during this time. States report data for each calendar month and we calculated the change in enrollment over 12-month period. Coverage is a point-in-time estimate of unduplicated number of children enrolled in Medicaid/CHIP who are receiving comprehensive benefits. Child is defined on a state-by-state basis. CHIP covers pregnant women in some states so there may be some adults included in the total number of enrollees. There were three states (Arizona, District of Columbia, and Tennessee) with no available data therefore we used the enrollment data below.

For the state of Arizona, we use enrollment data made available by the state. Because enrollment data is reported quarterly, we estimate change in enrollment using data from January 2018 and January 2019.

For the District of Columbia, we use enrollment data made available by the state. Because the District of Columbia has not updated enrollment data for December 2018, we estimate the change in enrollment using data from November 2017 to November 2018.

For Tennessee, we use enrollment data made available by the state. Because Tennessee does not report CoverKids enrollment data for 2017, we estimate the change in enrollment by comparing CoverKids and TennCare enrollment data from January 2018 and January 2019.

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