The U.S. Department of Health & Human Services (HHS) recently unveiled new data highlighting changes in state Medicaid and Children’s Health Insurance Program (CHIP) enrollment among children and youth. The data, which provides insights into enrollment trends since the full eligibility renewals for these programs resumed earlier this year, underscores the impact of federal strategies on child healthcare coverage.
States that have capitalized on federal strategies provided by the Centers for Medicare & Medicaid Services (CMS) and prioritized automatic renewals to cut through bureaucratic red tape have seen more eligible children renew their Medicaid and CHIP coverage. Many of these CMS strategies simplify the renewal process by leveraging data the states already possess.
However, barriers to coverage persist, leaving many children and youth uninsured. The ten states – Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming – that have yet to expand Medicaid have seen higher disenrollment rates among children compared to states that have expanded the program.
The continuous enrollment condition has particularly impacted youth who turned 19 during its implementation. In non-expansion states, these youths account for an average of 27.6% of disenrollments among children since March 2023, a stark contrast to the 12.1% in states that expanded their programs.
Despite these challenges, over 88 million people, including nearly 40 million children, were enrolled in Medicaid and CHIP as of September 2023. This marks a significant increase from the pre-pandemic figures in February 2020, when around 71 million people, including 35 million children, were enrolled in these programs.
In response to these findings, CMS has issued comprehensive guidance to states on strategies to safeguard Medicaid and CHIP coverage for children. The guidance also extends these federal strategies for states through the end of 2024.
Secretary Xavier Becerra has further addressed letters to the governors of nine states with the highest child disenrollment rates, urging them to adopt additional federal strategies to prevent coverage loss. These states – Arkansas, Florida, Georgia, Idaho, Montana, New Hampshire, Ohio, South Dakota, and Texas – account for approximately 60% of the decline in children’s Medicaid and CHIP enrollment from March to September 2023.
In his letter, Secretary Becerra called on these governors to ease renewals, remove barriers like CHIP enrollment fees and premiums, reduce call center wait times, partner with various stakeholders, and expand their Medicaid programs. These actions are designed to ensure that more people can access comprehensive, high-quality health coverage, regardless of whether it’s through Medicaid, CHIP, the Health Insurance Marketplaces, Medicare, or an employer.
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