In May, Wyoming received approval to transition its separate Children’s Health Insurance Program (CHIP) into what we call an M-CHIP program, where all children funded through CHIP coverage expansions are enrolled in Medicaid. Wyoming follows in the footsteps of North Dakota, Michigan, New Hampshire, and California – all of which converted their separate CHIP programs to Medicaid in the past decade. This brings the total of M-CHIP states to 17.
As background, states can operate CHIP as a separate program, use CHIP funds to expand Medicaid, or a combination of the two approaches. Most states (32) have a combination program with some kids in a separate CHIP program and some in a CHIP-funded Medicaid expansion. Only two states (CT and WA) have completely separate programs, with no CHIP-funded children in Medicaid. (See map below for each state’s operating approach).
As a former CHIP director, I have mixed feelings because I know the important role CHIP has played in our country’s success in advancing children’s health coverage with its dedicated focus on children. Medicaid serves four times as many children as CHIP but it also must focus attention on the needs of a much broader population including many people with more complex needs. But M-CHIP states can certainly use CHIP funds to dedicate a team to outreach and testing innovative enrollment strategies in Medicaid that better serve children.
Most importantly, I know that children benefit from the stronger protections in Medicaid, especially the critically important EPSDT benefit that helps children access screening, diagnosis, and necessary treatment services recommended by their pediatricians. Medicaid is also available without a waiting period and provides premiums and cost-sharing protections, including no lockouts for nonpayment of premium. Plus, there’s little doubt that it is more administratively efficient to run a single program. Operating CHIP as a Medicaid expansion also makes the coverage between the two programs seamless for families.
CHIP has taught us many lessons about how to improve our public coverage programs. If we blend the many benefits of Medicaid with the enhanced focus of CHIP on children through outreach and innovative strategies to streamline enrollment and retention, we get the best of all worlds.