Children’s Health Coverage: The Role of Medicaid and CHIP and Issues for the Future

Issue Brief
  1. According to CMS, as of May 2015, 2 states operate separate CHIP programs, 9 states operate Medicaid expansion CHIP programs, and 40 states operate combination programs. “Children’s Health Insurance Program,” Centers for Medicare and Medicaid Services, accessed April 26, 2016, https://www.medicaid.gov/chip/downloads/chip-map.pdf.

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  2. These enrollment numbers are unduplicated counts for FY 2014. “Annual Enrollment Reports,” Centers for Medicare and Medicaid Services, accessed May 3, 2016, https://www.medicaid.gov/chip/downloads/fy-2014-childrens-enrollment-report.pdf.

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  3. Kaiser Family Foundation State Health Facts. Data Source: Kaiser Commission on Medicaid and the Uninsured and Urban Institute estimates based on data from FY 2011 MSIS and CMS-64 reports, accessed May 5, 2016, https://www.kff.org/medicaid/state-indicator/medicaid-spending-by-enrollment-group/.

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  4. Kaiser Family Foundation State Health Facts. Data Source: Urban Institute analysis of CM Form 64 data as of June 2015, accessed May 5, 2016 https://www.kff.org/medicaid/state-indicator/total-medicaid-spending/. Estimate of spending for children in FY 2014 is the share of children’s spending in FY 2011 multiplied by Medicaid spending in FY 2014 without DSH spending.

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  5. Kaiser Family Foundation State Health Facts. Data Source: CHIP Spending by State, 2014, MACPAC, 2015, analysis of Medicaid and CHIP Budget Expenditure System (MBES/CBES) data from the Centers for Medicare & Medicaid Services as of March 6, 2015, access May 6, 2016, https://www.kff.org/other/state-indicator/total-chip-spending/.

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  6. Kaiser Family Foundation State Health Facts. Data Source: FY 2015: Federal Register, January 21, 2014 (Vol 79, No. 13), pp 3385-3388, accessed May 6, 2016, https://www.kff.org/medicaid/state-indicator/federal-matching-rate-and-multiplier/.

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  7. Kaiser Family Foundation State Health Facts. Data Source: FY 2015: Federal Register, January 21, 2014 (Vol 79, No. 13), pp 3385-3388, accessed May 5, 2016, https://www.kff.org/other/state-indicator/enhanced-federal-matching-rate-chip/.

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  8. Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey (Washington, DC, Kaiser Family Foundation, January 21, 2016), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-renewal-and-cost-sharing-policies-as-of-january-2016-findings-from-a-50-state-survey/.

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  9. Ibid.

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  10. Kaiser Family Foundation analysis of 2015 National Health Insurance Survey (NHIS) data.

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  11. Julia Paradise, The Impact of the Children’s Health Insurance Program (CHIP): What Does the Research Tell Us? (Washington, DC, Kaiser Family Foundation, July 2014), https://www.kff.org/medicaid/issue-brief/the-impact-of-the-childrens-health-insurance-program-chip-what-does-the-research-tell-us/.

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  12. Ibid.

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  13. David Brown, Amanda Kowalski, and Ithai Lurie, Medicaid as an Investment in Children: What is the Long-Term Impact on Tax Receipts? (Washington, DC, National Bureau of Economic Research, January 2015), http://www.nber.org/papers/w20835.

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  14. Michael Perry and Julia Paradise, Enrolling Children in Medicaid and SCHIP: Insights from Focus Groups with Low-Income Parents (Washington, DC, Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, May 2007), https://www.kff.org/wp-content/uploads/2013/01/7640.pdf.

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  15. Robin Rudowitz, Children’s Coverage: What Matters Most to Parents Results from Focus Groups in 6 Cities (Washington, DC, Kaiser Family Foundation, June 2015), https://www.kff.org/medicaid/issue-brief/childrens-coverage-what-matters-most-to-parents-results-from-focus-groups-in-6-cities/.

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  16. Mira Norton, Bianca DiJulio, and Mollyann Brodie. Medicare and Medicaid at 50. (Kaiser Family Foundation, July 2015), https://www.kff.org/medicaid/poll-finding/medicare-and-medicaid-at-50/

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  17. Kaiser Family Foundation State Health Facts. Data Source: FY 2017: Federal Register, November 25, 2015 (Vol 80, No. 227), pp 73779-73782, assessed on May 6, 2016, https://www.kff.org/other/state-indicator/enhanced-federal-matching-rate-chip/.

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  18. 42 U.S.C. §1397.

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  19. Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey (Washington, DC, Kaiser Family Foundation, January 21, 2016), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-renewal-and-cost-sharing-policies-as-of-january-2016-findings-from-a-50-state-survey/.

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  20. Ibid.

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  21. Ibid.

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  22. Genevieve Kenney, Jennifer Haley, Clare Wang Pan, Victoria Lynch and Matthew Buettgens, Children's Coverage Climb Continues: Uninsurance and Medicaid/ CHIP Eligibility and Participation Under the ACA (Washington, DC, Urban Institute, May 2016), http://www.urban.org/research/publication/childrens-coverage-climb-continues-uninsurance-and-medicaid-chip-eligibility-and-participation-under-aca.

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  23. Kaiser Family Foundation analysis of the National Health Interview Survey (NHIS) Data for years 1997 to 2014.

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  24. Kaiser Family Foundation estimates based on analysis of the March 2015 ASEC Supplement to the CPS.

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  25. Kaiser Family Foundation estimates based on analysis of the March 2015 ASEC Supplement to the CPS.

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  26. Kaiser Family Foundation estimates based on analysis of the March 2015 ASEC Supplement to the CPS.

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  27. Melissa Majerol, Vann Newkirk, and Rachel Garfield, The Uninsured: A Primer Key Facts about Health Insurance and the Uninsured in the Era of Health Reform (Washington, DC, Kaiser Commission on Medicaid and the Uninsured, November 2015), https://www.kff.org/uninsured/report/the-uninsured-a-primer-key-facts-about-health-insurance-and-the-uninsured-in-the-era-of-health-reform/.

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  28. Kaiser Family Foundation estimates based on analysis of the March 2015 ASEC Supplement to the CPS.

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  29. Sonya Schwartz, Alisa Chester, Steven Lopez, and Samantha Vargas Poppe, Historic Gains in Health Coverage for Hispanic Children in the Affordable Care Act’s First Year (Washington, DC, Georgetown University, Health Policy Institute, Center for Children and Families, January 2016), http://ccf.georgetown.edu/wp-content/uploads/2016/01/CCF-NCLR-Uninsured-Hispanic-Kids-Report-Final-Jan-14-2016.pdf.

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  30. Oscar C. Gomez, Liberty Day, and Samantha Artiga, Connecting Eligible Families to Health Coverage and Care: Key Lessons from Outreach and Enrollment Workers (Washington, DC, Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, October 2011), https://www.kff.org/disparities-policy/issue-brief/connecting-eligible-immigrant-families-to-health-coverage/.

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  31. Samantha Artiga and Anthony Damico, Medicaid and American Indians and Alaska Natives (Washington, DC, Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, March 2016), https://www.kff.org/medicaid/issue-brief/medicaid-and-american-indians-and-alaska-natives/.

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  32. Kaiser Family Foundation estimates based on analysis of the March 2015 ASEC Supplement to the CPS.

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  33. Kaiser Family Foundation analysis based on 2015 Medicaid eligibility levels updated to reflect state Medicaid expansion decisions as of January 2016 and 2015 Current Population Survey data.

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  34. Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2016: Findings from a 50-State Survey (Kaiser Family Foundation, January 21, 2016), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-renewal-and-cost-sharing-policies-as-of-january-2016-findings-from-a-50-state-survey/.

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  35. Kaiser Family Foundation analysis based on 2015 Medicaid eligibility levels updated to reflect state Medicaid expansion decisions as of January 2016 and 2015 Current Population Survey data.

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  36. Ibid.

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  37. Ibid.

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  38. Ibid.

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  39. Certification of Comparability of Pediatric Coverage Offered by Qualified Health Plans (Centers for Medicare and Medicaid Services, November 2015), https://www.medicaid.gov/chip/downloads/certification-of-comparability-of-pediatric-coverage-offered-by-qualified-health-plans.pdf.

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  40. Ibid.

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  41. Affordability of Exchange Coverage for Children Now Covered by CHIP (Medicaid and CHIP Payment and Access Commission, March 2015), https://www.macpac.gov/publication/affordability-of-exchange-coverage-for-children-now-covered-by-chip-2/.

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  42. Robin Rudowitz, Children’s Coverage: What Matters Most to Parents Results from Focus Groups in 6 Cities (Kaiser Family Foundation, June 2015), https://www.kff.org/medicaid/issue-brief/childrens-coverage-what-matters-most-to-parents-results-from-focus-groups-in-6-cities/.

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  43. “CMS Announces $32 Million to Increase Number of Children with Quality, Affordable Health Coverage,” accessed June 24, 2016. http://www.hhs.gov/about/news/2016/06/13/cms-announces-32-million-increase-number-children-with-quality-affordable-health-coverage.html.

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  44. Ibid.

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  45. Ibid.

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  46. Ibid.

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  47. Vikki Wachino, Strategies to Enroll and Retain Eligible Children in Medicaid and CHIP (Center for Medicare and Medicaid Services, June 2016), https://www.medicaid.gov/federal-policy-guidance/downloads/cib061316.pdf.

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