A wide range of organizations, including state/local governments, tribal entities, safety net providers, non-profits, schools, and others, may apply for up to $1.5 million over three years to connect eligible people to Medicaid or CHIP under a new CMS funding opportunity. A total of $49.4 million in funding will build on efforts initiated by the 2009 CHIP Reauthorization Act (CHIPRA) when Congress began to commit ongoing funding to boost outreach and enrollment efforts. Since CHIPRA took effect, $216 million has been awarded to more than 294 community-based organizations, states, and local governments to support the enrollment and retention of eligible children in Medicaid and CHIP, according to the CMS announcement.

Importantly, this funding round is broader than enrollment and renewal assistance for children and families. It includes pregnant people as a target population this round. Stay tuned for a second blog from my colleague, Maggie Clark, on the helpful ways this funding opportunity can capitalize on momentum in policy and public health efforts to improve maternal health.

Applicants may consider a range of activities, including, but not limited to:

• Engaging schools and other programs serving young people;
• Bridging racial and demographic health coverage disparities by targeting communities with low coverage rates;
• Establishing and developing application assistance resources to provide high-quality, reliable enrollment and renewal services in local communities;
• Using social media to conduct virtual outreach and enrollment assistance; and
• Using parent mentors and community health workers to assist families with enrolling in Medicaid and CHIP, retaining coverage, and addressing social determinants of health.

Outreach efforts will be critical as states resume normal operations after the lifting of the continuous enrollment requirement. If history repeats itself, a number of children could lose health coverage due to procedural (non-eligibility) reasons when the COVID-related continuous enrollment requirement in Medicaid is lifted. Recent analysis by MACPAC indicates that nearly 1 in 5 children who were enrolled in Medicaid or CHIP experienced a gap in coverage at some point during the year examined (2018). Almost half of those children re-enrolled within 12 months. But as states catch up on delayed renewals and other pending actions, eligibility workers and call centers may be overwhelmed with the sheer volume of work. As a result, eligible enrollees may be unable to access assistance in retaining coverage, resulting in even greater numbers of children who churn off the program and experience a gap in coverage for even longer periods of time despite the fact that they remain eligible. Outreach to these families may help prevent eligible children from losing coverage or assist in re-enrolling children who experience a gap in enrollment.

Outreach and enrollment grant funding is currently authorized through FFY 2027 with $120 million available for grantmaking in FFYs 2018-2023 and $48 million in FFYs 2024-2027. Of note, the law also explicitly allows parent mentors to be compensated for their work. This is a promising strategy to reach eligible but unenrolled children, especially in racial and ethnic minority communities, and would help narrow known racial disparities in insurance coverage. You can find more information on this grant opportunity here. Proposals are due March 28, 2022.