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As more U.S. children and their families qualify each year for Medicaid, the mechanics of ensuring that their coverage does not lapse have become more complicated. Now, the omnibus spending bill heading toward Congress appears to be taking the lead in keeping that coverage intact from year to year.
The bill – which is expected to pass next year – would require all states to adopt continuous eligibility for children in both Medicaid and CHIP. Under current law, states have the option to provide 12 months of continuous coverage for children in Medicaid and/or separate CHIP. This potential change inspired the Kaiser Family Foundation to review records of states that currently offer continuous coverage for children and those that do not, to see what the lapse, or "churn" rate, was among the two groups five years ago.
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What KFF found was that far fewer children left their Medicaid coverage in the states that support 12 months of continuous coverage. Only half as many children lost coverage during the 12 month period studies in states with continuous coverage. Looking at a longer period of time, KFF found that, at 15 months, the child churn rate nearly tripled in those states. But it was still far below the churn rate in states that did not offer 12 months of continuous coverage.
Based on its analysis, KFF heartily endorsed the measure included in the omnibus spending act that would require all states to offer 12 months of continuous Medicaid coverage.
Even better: states can already apply for multi-year coverage for children through the Centers for Medicare and Medicaid Services. Oregon's application for an extension has already been approved, and other states are pursuing this route.
The data review found that Hispanic children have the highest churn rate among major ethnic groups, followed by African American, white and Asian children.
"Our findings indicate that 12-month continuous eligibility policies are effective tools to reduce Medicaid disenrollment and churn rates within the year. However, some children may still lose coverage at annual renewal regardless of state adoption of 12-month continuous eligibility, and multi-year continuous eligibility policies could help children maintain coverage beyond one year and keep children from losing coverage during the renewal process," the report says.
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Dan Cook
Dan Cook is a journalist and communications consultant based in Portland, OR. During his journalism career he has been a reporter and editor for a variety of media companies, including American Lawyer Media, BusinessWeek, Newhouse Newspapers, Knight-Ridder, Time Inc., and Reuters. He specializes in health care and insurance related coverage for BenefitsPRO.
