Retention

Research suggests retaining eligible children is a critical element in states’ efforts to enroll eligible children in Medicaid and CHIP. One recent study indicated that 42 percent of eligible but uninsured children had actually been enrolled in CHIP or Medicaid the previous year. Without stable health insurance, many children miss out on stable health care and states must deal with administrative burdens and costs created by children churning on and off public coverage. Additionally, when family status and income changes, a child’s eligibility may shift from Medicaid to CHIP. One study estimated that as many as 2.4 million children may transition between Medicaid and CHIP each year, creating new opportunities for children to lose coverage as they transition between programs.

States have employed a number of strategies that have proven effective to improve retention of coverage among eligible children. Coordinating between Medicaid and CHIP coverage policies, procedures and systems has proven effective in minimizing loss of coverage during transitions. In addition, implementing strategies like 12-month continuous eligibility for Medicaid and CHIP, guaranteed eligibility regardless of income changes, and administrative renewals that minimize the need to fill out paperwork to renew coverage are all strategies states have implemented with positive results so far.

Maximizing Enrollment for Kids will assist grantee states to improve their retention of eligible children and reduce churning, the extent to which children lose and then regain coverage. The goals of the program are designed to address states’ enrollment and retention challenges. More specifically, regular analysis of state-supplied data will help states measure how changes in retention relate to improvements in state systems, policies, and procedures. Through this work, Maximizing Enrollment for Kids aims to test strategies, explore new ideas, and share information that can improve states' ability to retain even greater numbers of children eligible for Medicaid and CHIP.