Recent Medicaid/CHIP Enrollment Declines and Barriers to Maintaining Coverage

Issue Brief
  1. Kaiser Family Foundation, Analysis of Recent Declines in Medicaid and CHIP Enrollment (Washington, DC: Kaiser Family Foundation, May 2019), https://www.kff.org/medicaid/fact-sheet/analysis-of-recent-declines-in-medicaid-and-chip-enrollment/

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  2. Kaiser Family Foundation, Total Monthly Medicaid and CHIP Enrollment, (Washington, DC: Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

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  3. Seema Verma, “Thank Obamacare for the Rise of the Uninsured”, Centers for Medicare & Medicaid Services, September 13, 2019, https://www.cms.gov/blog/thank-obamacare-rise-uninsured and Harris Meyer, “Faulty state renewal processes blamed for Medicaid coverage declines,” Modern Healthcare”, April 19, 2019, https://www.modernhealthcare.com/government/faulty-state-renewal-processes-blamed-medicaid-coverage-declines

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  4. United States Census Bureau, Health Insurance Coverage in the United States: 2018, (Washington, DC: U.S. Census Bureau, September 10, 2019), https://www.census.gov/library/publications/2019/demo/p60-267.html

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  5. Michael Perry, Susan Kannel, R. Burciaga Valdez, and Christina Chang, Medicaid and Children: Overcoming Barriers to Enrollment, Findings from a National Survey, (Washington, DC: Kaiser Family Foundation, January 2000), https://www.kff.org/medicaid/report/medicaid-and-children-overcoming-barriers-to-enrollment/

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  6. Kaiser Family Foundation, Key Lessons from Medicaid and CHIP for Outreach and Enrollment Under the Affordable Care Act, (Washington, DC: Kaiser Family Foundation, June 4, 2013), https://www.kff.org/medicaid/issue-brief/key-lessons-from-medicaid-and-chip-for-outreach-and-enrollment-under-the-affordable-care-act/

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  7. Ibid.

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  8. Ibid.

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  9. Anne Dunkelberg and Molly O’Malley, Children’s Medicaid and SCHIP in Texas: Tracking the Impact of Budget Cuts, (Washington, DC: Kaiser Commission on Medicaid and the Uninsured, July 2004), http://www.kff.org/medicaid/7132.cfm

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  10. 42 CFR § 435.916 and Kaiser Family Foundation, Medicaid Eligibility, Enrollment Simplification, and Coordination under the Affordable Care Act: A Summary of CMS’s March 23, 2012 Final Rule, (Washington, DC: Kaiser Family Foundation, December 2012), https://www.kff.org/medicaid/issue-brief/medicaid-eligibility-enrollment-simplification-and-coordination-under-the-affordable-care-act-a-summary-of-cmss-march-23-2012-final-rule/

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  11. Ibid.

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  12. Ibid.

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  13. Ibid.

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  14. Ibid.

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  15. Ibid.

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  16. Center for Medicaid and CHIP Services, CMCS Informational Bulletin: Oversight of State Medicaid Claiming and Program Integrity Expectations (June 20, 2019), https://www.medicaid.gov/federal-policy-guidance/downloads/cib062019.pdf

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  17. Tricia Brooks, Lauren Roygardner, and Samantha Artiga, Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey, (Washington, DC: Kaiser Family Foundation, March 2019), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/

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  18. Shefali Luthra, “In Texas, People With Fluctuating Incomes Risk Being Cut Off From Medicaid,” National Public Radio, June 4, 2017, https://www.npr.org/sections/health-shots/2017/06/14/532816157/in-texas-people-with-fluctuating-incomes-risk-being-cut-off-from-medicaid

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  19. H.B. 1270, Oklahoma State Legislature, 56th Legislature (2017), accessed September 13, 2019, http://www.oklegislature.gov/BillInfo.aspx?Bill=hb1270&Session=1800

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  20. Oklahoma Health Care Authority, OHCA Changes Member Outreach Related to Undeliverable Mail (2019), accessed September 16, 2019, http://www.okhca.org/about.aspx?id=23526

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  21. 42 CFR § 435.603 and Kaiser Family Foundation, Medicaid Eligibility, Enrollment Simplification, and Coordination under the Affordable Care Act: A Summary of CMS’s March 23, 2012 Final Rule, (Washington, DC: Kaiser Family Foundation, December 2012), https://www.kff.org/medicaid/issue-brief/medicaid-eligibility-enrollment-simplification-and-coordination-under-the-affordable-care-act-a-summary-of-cmss-march-23-2012-final-rule/

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  22. Tricia Brooks, Lauren Roygardner, and Samantha Artiga, Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey, (Washington, DC: Kaiser Family Foundation, March 2019), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/

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  23. Kaiser Family Foundation, Analysis of Recent Declines in Medicaid and CHIP Enrollment (Washington, DC: Kaiser Family Foundation, May 2019), https://www.kff.org/medicaid/fact-sheet/analysis-of-recent-declines-in-medicaid-and-chip-enrollment/

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  24. Kaiser Family Foundation, Total Monthly Medicaid and CHIP Enrollment, (Washington, DC: Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

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  25. Seema Verma, “Thank Obamacare for the Rise of the Uninsured”, (Washington, DC: Centers for Medicare & Medicaid Services, September 13, 2019), https://www.cms.gov/blog/thank-obamacare-rise-uninsured and Harris Meyer, “Faulty state renewal processes blamed for Medicaid coverage declines,” Modern Healthcare”, April 19, 2019, https://www.modernhealthcare.com/government/faulty-state-renewal-processes-blamed-medicaid-coverage-declines

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  26. United States Census Bureau, Health Insurance Coverage in the United States: 2018, (Washington, DC: U.S. Census Bureau, September 10, 2019), https://www.census.gov/library/publications/2019/demo/p60-267.html

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  27. Kaiser Family Foundation, Total Monthly Medicaid and CHIP Enrollment, (Washington, DC: Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

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  28. Austin Huguelet, “The trouble with Missouri's Medicaid system, explained,” Springfield News-Leader, August 24, 2019, https://www.news-leader.com/story/news/politics/2019/08/25/missouri-medicaid-system-election-politics-expansion/2095153001/; Sandra Jordan, “More than 50K eligible children dropped from Medicaid in MO,” The St. Louis American, February 12, 2019, http://www.stlamerican.com/news/local_news/more-than-k-eligible-children-dropped-from-medicaid-in-mo/article_54ae22d6-2ef9-11e9-9d98-776256fd3473.html; and, Sarah Fentem, “More Than Half of Missourians Who Were Dropped From Medicaid Didn’t Answer Mail,” St. Louis Public Radio, March 19, 2019, https://news.stlpublicradio.org/post/more-half-missourians-who-were-dropped-medicaid-didnt-answer-mail#stream/0

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  29. Harris Meyer, “Faulty state renewal processes blamed for Medicaid coverage declines,” Modern Healthcare”, April 19, 2019, https://www.modernhealthcare.com/government/faulty-state-renewal-processes-blamed-medicaid-coverage-declines

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  30. Brett Kelman and Mike Reicher, “At least 220,000 Tennessee kids faced loss of health insurance due to lacking paperwork,” July 14, 2019, https://www.tennessean.com/story/news/investigations/2019/07/14/tenncare-coverkids-medicaid-children-application-insurance-denied/1387769001/

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  31. Kaiser Family Foundation, Analysis of Recent Declines in Medicaid and CHIP Enrollment (Washington, DC: Kaiser Family Foundation, May 2019), https://www.kff.org/medicaid/fact-sheet/analysis-of-recent-declines-in-medicaid-and-chip-enrollment/

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  32. Kaiser Family Foundation, Total Monthly Medicaid and CHIP Enrollment, (Washington, DC: Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

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  33. Ibid.

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  34. Robin Rudowitz, MaryBeth Musumeci, and Cornelia Hall, February State Data for Medicaid Work Requirements in Arkansas, (Washington, DC: Kaiser Family Foundation, March 25, 2019), https://www.kff.org/medicaid/issue-brief/state-data-for-medicaid-work-requirements-in-arkansas/ and Kaiser Family Foundation, Medicaid Waiver Tracker: Approved and Pending Section 1115 Waivers by State, (Washington, DC: Kaiser Family Foundation), August 21, 2019, https://www.kff.org/medicaid/issue-brief/medicaid-waiver-tracker-approved-and-pending-section-1115-waivers-by-state/

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  35. Benji Hardy, “Many factors affect Arkansas’ drop in Medicaid numbers,” Southwest Times Record, August 11, 2018, https://www.swtimes.com/news/20180811/many-factors-affect-arkansas-drop-in-medicaid-numbers and Benjamin Hardy, “Scrubbed from the system,” Arkansas Times, August 9, 2018, https://arktimes.com/news/cover-stories/2018/08/09/scrubbed-from-the-system

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  36. Benji Hardy, “Many factors affect Arkansas’ drop in Medicaid numbers,” Southwest Times Record, August 11, 2018, https://www.swtimes.com/news/20180811/many-factors-affect-arkansas-drop-in-medicaid-numbers

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  37. MaryBeth Musumeci, Robin Rudowitz, and Barbara Lyons, Medicaid Work Requirements in Arkansas: Experience and Perspectives of Enrollees, (Washington, DC: Kaiser Family Foundation, December 18, 2019), https://www.kff.org/medicaid/issue-brief/medicaid-work-requirements-in-arkansas-experience-and-perspectives-of-enrollees/.

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  38. Sam Karlin, “Medicaid expansion enrollment dips slightly, down 50,000 from peak amid new wage check system,” The Advocate, July 23, 2019, https://www.theadvocate.com/baton_rouge/news/politics/article_65b3058a-ad96-11e9-a99f-1303ae422bd6.html

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  39. Ibid.

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  40. Sam Karlin, “Louisiana health department temporarily halts automatic closure of thousands of Medicaid enrollees,” The Advocate, August 6, 2019, https://www.theadvocate.com/baton_rouge/news/politics/article_600c43f8-b872-11e9-ac88-8f9e60eced18.html

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  41. Ibid.

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  42. In Texas, children enrolled in the state’s separate CHIP with income up to 185 percent FPL receive 12 months continuous eligibility (the eligibility upper limit is 206 percent FPL). Those with income between 185 and 206 percent FPL are subject to only one review at six months of enrollment.

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  43. Shefali Luthra, “In Texas, People With Fluctuating Incomes Risk Being Cut Off From Medicaid,” NPR, June 14, 2017, https://www.npr.org/sections/health-shots/2017/06/14/532816157/in-texas-people-with-fluctuating-incomes-risk-being-cut-off-from-medicaid

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  44. Allie Morris, “50,000 Texas children a year lose Medicaid over paperwork. A bill to change that died.” Houston Chronicle, May 10, 2019, https://www.houstonchronicle.com/news/politics/texas/article/50-000-Texas-children-a-year-lose-Medicaid-over-13835990.php

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  45. Kaiser Family Foundation, Total Monthly Medicaid and CHIP Enrollment, (Washington, DC: Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-monthly-medicaid-and-chip-enrollment/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D

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  46. Tricia Brooks, Lauren Roygardner, and Samantha Artiga, Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2019: Findings from a 50-State Survey (Washington, DC: Kaiser Family Foundation, March 2019), https://www.kff.org/medicaid/report/medicaid-and-chip-eligibility-enrollment-and-cost-sharing-policies-as-of-january-2019-findings-from-a-50-state-survey/

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  47. Seema Verma, Medicaid Program Integrity: A Shared and Urgent Responsibility, (Washington, DC: Centers for Medicare and Medicaid Services, June 25, 2019), https://www.cms.gov/blog/medicaid-program-integrity-shared-and-urgent-responsibility

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