Biden-Harris administration releases new Medicaid and CHIP reform data showing role of state policy choices in keeping children safe

Sec. Becerra calls on the nine states with the highest rates of child separation to immediately implement proven federal resilience measures to protect children and families; The Biden-Harris administration will extend federal flexibility to states until the end of 2024

The U.S. Department of Health and Human Services (HHS) today released new data on state Medicaid and Children’s Health Insurance Program (CHIP) enrollment changes among children and youth as full eligibility renewals for these programs began again earlier this year. Data released today make it clear that state policy choices have real consequences for children and families during Medicaid and CHIP reforms. States that implement proven flexibilities and strategies from the Centers for Medicare & Medicaid Services (CMS) are better able to protect children’s coverage, especially when the state has also expanded Medicaid.

According to the information:

  • States that have adopted more of the federal strategies offered by CMS and prioritized automatic renewals (ex parte) reducing red tape for families has helped more eligible children renew Medicaid and CHIP coverage. Many of the flexibilities of the content management system make it easier for states to renew coverage of eligible children using information already available to the state.
  • Barriers to coverage, such as the failure to expand Medicaid, cause children and youth to fall through the cracks. For example, the 10 states that have not expanded Medicaid—Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin, and Wyoming—have left more children behind than those that have expanded combined. In non-expansion states, youth who turned 19 while the requirement for continuous enrollment was in effect are at risk of falling into the coverage gap and becoming uninsured; These youth account for an average of 27.6% of child dropouts in non-expansion states as of March 2023, compared to 12.1% in expansion states.
  • More than 88 million people, including nearly 40 million children and youth, were enrolled in Medicaid and CHIP coverage in September 2023. Before the pandemic, in February 2020, about 71 million people were enrolled in Medicaid and CHIP, including about 35 million children . .

In light of this information, CMS issued comprehensive new guidance to states on strategies to protect Medicaid and CHIP coverage for children during this regular Medicaid and CHIP overhaul. The guidelines also announced the extension of these federal strategies to the states until the end of 2024.

Secretary Becerra also sent letters to the governors of the nine states with the highest numbers and percentages of children dropping out, urging them to implement additional federal strategies and flexibility to prevent children and their families from losing coverage due to red tape. These states include Arkansas*, Florida*, Georgia*, Idaho*, Montana*, New Hampshire*, Ohio*, South Dakota* and Texas*. These nine states account for about 60% of the decline in children’s Medicaid and CHIP enrollments from March to September 2023, according to a data release released today. This is especially important for children and families of color, who are likely to suffer disproportionately.

I urge you to ensure that no eligible child in your state loses health insurance because of red tape or other bureaucratic hurdles during the Medicaid enrollment process, said Secretary Becerra.

Because eligibility thresholds for children tend to be higher than for adults, many expelled children may still meet essential Medicaid or CHIP eligibility requirements, underscoring the need for states to take additional steps to prevent eligible children from falling through the cracks. In his letter, Secretary Becerra urged these governors:

  • Implements dozens of federal flexibilities and strategies developed to make renewal easier for children and families, including by leveraging the guidance and tools CMS released today;
  • Remove barriers, such as CHIP enrollment fees and premiums, that make it difficult for children to transition to CHIP coverage if they no longer qualify for Medicaid.
  • Reach more families by reducing call center wait times and partnering with child providers, managed care plans, schools and community organizations. and
  • Expand their Medicaid programs, if states have not already done so, to ensure that young adults over the age of 18 have affordable coverage options and do not fall into the coverage gap.

Today’s actions reflect HHS’s continued commitment to helping people get comprehensive, high-quality health care, whether through Medicaid, CHIP, the health insurance marketplaces, Medicare, or through an employer. To date, HHS, through CMS, has provided states with comprehensive guidance on federal Medicaid and CHIP renewal requirements, approved nearly 400 flexibilities for states to facilitate renewals, and made a special enrollment period available on to help people who no longer have coverage. eligible for Medicaid’s transition to Marketplace coverage, engaged with public and private sector stakeholders and conducted extensive outreach and advertising efforts to raise awareness of the return of regular Medicaid and CHIP reforms. HHS continues to closely monitor states’ renewal efforts to ensure they are in compliance with federal Medicaid renewal requirements and will take action if it finds noncompliance.

CMS is doing everything we can to protect access to health care during the Medicaid and CHIP reform process, especially for children, said CMS Administrator Chiquita Brooks-LaSure. That’s why we’ve presented dozens of strategies to states to protect children’s and families’ ability to stay protected. Many states have worked with us to adopt the strategies we put on the table, and we encourage all states to do their part to ensure that eligible children keep the coverage they need to grow and thrive.

In addition to this information release on children and youth, CMS is releasing a CMS bulletin highlighting steps states can take to help keep eligible children enrolled in Medicaid and CHIP and announcing for the first time that (e)(14) flexibilities will be utilized. at least until the end of 2024, giving states even more opportunities to implement these strategies; new guidance to support transitions to other coverage, including from Medicaid to CHIP, and additional guidance to help states implement CMS strategies and flexibilities to promote continuity of coverage; and information describing other enrollment trends during renewal, including health insurance marketplace enrollment trends.

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