CHIP ENROLLMENT: States Make ‘Strong Progress,’ HCFA Says
In a report covering the 50 states, the District of Columbia and five U.S. territories, HCFA concludes that many localities have made "strong progress" in enrolling children in their Children's Health Insurance Programs, bumping total enrollment numbers up to two million children as of July 1. The report, "The State Children's Health Insurance Program: Preliminary Highlights of Implementation and Expansion," uses data each state provided to assess the program's overall success. According to the report, from the second quarter of fiscal year 1999 (April 1 through June 30) to the second quarter of fiscal year 2000, 43 states experienced combined enrollment increases of more than 80%. During the same time period, 19 states reported their enrollment more than doubled, while nine of those states reported that their enrollment tripled. These "strong enrollment trends" are expected to continue through the first quarter of 2000, the report states. One reason for the programs' increased enrollment is that states are working "aggressively to simplify their application, enrollment and re-enrollment processes." As part of this simplification process, 29 states now use a joint application to enroll families in both Medicaid and CHIP, while 39 states have eliminated face-to-face interviews. Only seven states retain assets tests, which require families to provide extensive information concerning their non-income assets to the state to determine eligibility. Ten states allow children to enroll in Medicaid or CHIP on a temporary basis, using information the family supplies until the "appropriate" state agency makes the final eligibility determination. In addition, 32 states enroll children for 12 consecutive months, regardless of any changes in family income or circumstances. States also have implemented various outreach programs through schools or community-based organizations to enroll children and keep them in the program ("The State Children's Health Insurance Program: Preliminary Highlights of Implementation and Expansion," July 2000). Further CHIP enrollment information can be found in the recent Kaiser Family Foundation report, "CHIP Program Enrollment: December 1998 to December 1999," available at http://kff.org/content/2000/2195/CHIPEnrollmentJuly2000.PDF .
Having received reports that states were not making necessary adjustments to ensure that eligible families moving off welfare retained their health benefits, HCFA has performed "comprehensive, on-site reviews" of each state's Medicaid/CHIP enrollment and eligibility policies. The report notes that there are "serious problems" in a number of states. For example, some states have disenrolled families from Medicaid without first determining whether the family still is eligible. In addition, some states have experienced problems with reprogramming their computer systems, and as a result, some families' Medicaid benefits were "automatically terminated," even though the family was eligible for Medicaid coverage ("The State Children's Health Insurance Program: Preliminary Highlights of Implementation and Expansion," July 2000). The full report is available on the HCFA Web site, www.hcfa.gov.