On June 13, 2016, the Centers for Medicare and Medicaid Services (CMS) announced $32 million in grant awards supporting innovative strategies to enroll and retain children in Medicaid and the Children’s Health Insurance Program (CHIP). Innovation awardees include 38 state, local, and provider-based organizations in 27 states, such as the Los Angeles Unified School District (involving multi-lingual outreach information at over 800 district sites), the Bexar County Hospital District in Texas, and the Refuah Health Center, Inc. in New York State.
CMS concurrently released an information bulletin strongly encouraging states to consider seven proven Medicaid and CHIP outreach and enrollment strategies already successfully implemented in many states. Examples include:
- Express Lane Eligibility, which 11 states have adopted for Medicaid and seven states have adopted for CHIP, using eligibility data from SNAP, TANF, WIC, Head Start, and School Lunch programs to streamline the Medicaid/CHIP eligibility process;
- Presumptive Eligibility, which 18 states have adopted for children in Medicaid and 12 have adopted for CHIP, under which a broad range of health care providers, community based organizations, and schools have been authorized to determine Medicaid/CHIP eligibility;
- Continuous Eligibility, which 24 states have adopted for Medicaid and 28 states have adopted for CHIP, under which children can remain Medicaid/CHIP eligible for 12 months regardless of changes in family circumstances.
CMS estimates that more than 60 percent of the 4.5 million children who remain without health coverage are eligible for coverage, but unenrolled. Additional information on proven Medicaid/CHIP outreach and enrollment strategies and the new grants to enrollment innovators is available here.