- Almost all states can boost outreach and consumer assistance without hitting the 10 percent cap on overall CHIP administrative expenses.6 The majority of states have ample room to significantly increase outreach and consumer assistance. In fact, in 2020, 40 states had administrative expenses that were 5 percent or less of total CHIP expenditures (see Figure 1 and Appendix table 1). This means that states can leverage additional federal funding to cover between 69 percent and 85 percent of costs associated with public education, outreach and community-based assistance to help with Medicaid renewals and transitions between Medicaid and separate CHIP programs.
- Although all states are required by law to conduct outreach to families of children likely to be eligible for CHIP or Medicaid and assist them in enrolling their children, less than one-third of states (13) reported direct expenditures for outreach in the 2020 CHIP Annual Financial Management Report (FMR). Only 11 of those states (AL, CO, IN, IA, MD, NY, OR, PA, VA, VT and WY) consistently reported outreach expenditures in each of the three years included in the analysis—2018 to 2020 (see Appendix table 2). While it may be that other states include outreach expenses in their general administrative costs, without transparency in these data, it is unclear if or to what extent states are conducting outreach and meeting their statutory obligation.
- States should focus more funding and resources on children of color and households with limited English proficiency who historically have higher uninsured rates. Only one state (OR) reported outreach expenditures focused on American Indian and Alaska Native children (AI/AN), even though these expenditures do not count toward the 10 percent CHIP administrative cap. Native American children are nearly 2.5 times more likely to be uninsured compared to the national uninsured rate for all children (13.8 percent compared to 5.7 percent in 2019). Yet, none of the 10 states with the highest number of AI/AN children (AK, AZ, CA, MT, NM, NC, OK, SD, TX, and WA) reported direct outreach expenditures focused on Native children.7