Continuous Coverage in Medicaid and CHIP

Executive Summary

Continuous health insurance coverage produces a broad array of benefits across the health care sector for individuals, states, health plans, and providers. In particular, Medicaid continuous eligibility promotes health equity by limiting gaps in coverage for low-income children and adults who experience disproportionate rates of health disparities. Consistent access to health care, including management of chronic conditions and care coordination, improves health status and well-being and drives more efficient health care spending. Importantly, continuous eligibility mitigates the negative effects of income volatility that disproportionately impact low-income families and essential workers. By reducing the administrative costs associated with enrollees cycling on and off of Medicaid due to temporary fluctuations in income, states can dedicate more of the Medicaid dollar to pay for health care. Moreover, continuous eligibility is necessary to fully measure the quality of health care in Medicaid and the Children’s Health Insurance Program (CHIP), which also opens the door to improved accountability and oversight of insurers including Medicaid managed care plans.

State Take-Up of 12-Month Continuous Eligibility for Children

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Medicaid Continuous Eligibility Linked with Better Health, More Efficient Health Care Spending