Majority of States Increased Medicaid, CHIP Access in 2010

The majority of states increased their Medicaid and Children’s Health Insurance Program (CHIP) eligibility and enrollments in 2010, even as they struggled with deep budget deficits, courtesy of the Great Recession.  This is one finding of a 50-state survey conducted by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU).  According to the survey, 48 states and Washington, D.C., remained steady or made targeted improvements in their Medicaid and CHIP eligibility rules and enrollment procedures.  Another 13 states expanded eligibility, primarily for children; an additional 14 states made improvements in enrollment and renewal procedures that reduced burdens on families and streamlined administrative processes.

The 10th annual KCMU 50-state survey of Medicaid and CHIP eligibility rules, enrollment and renewal procedures and cost sharing practices determined that coverage policies held steady or even expanded, especially for low-income children.  The 2010 study was conducted with the Georgetown University Center for Children and Families.

Eligibility for their parents and other low-income adults still lag behind.  The stability of these programs during a recession that has sharply increased unemployment and declines in state tax revenues is primarily a result of the temporary federal fiscal relief for Medicaid provided by the American Recovery and Reinvestment Act of 2009 (ARRA).

“Millions of American families have turned to Medicaid and CHIP as incomes have declined after losing jobs and the health insurance that often goes with them,” said Diane Rowland, Executive Vice President of the Foundation and Executive Director of the KCMU.  “Keeping these programs stable and strong has helped protect children and avoid an even larger increase in the nation’s 50 million uninsured, and will be key to ensuring the success of health reform implementation over the next few years.”

Job loss and falling incomes mean that five million Americans no longer have employment-based health insurance.  As a result, Medicaid enrollment soared by 3.78 million between December 2008 and the same month of 2009.  That’s the largest yearly increase since Medicaid debuted in the 1960s.  Additionally, Medicaid enrollment has climbed by six million individuals since the recession began in 2007.  In December of 2009, fully 48 million Americans received their sole healthcare coverage through Medicaid.  People who did not meet the eligibility requirements are now uninsured.

In Vermont,  for example, families of children who receive benefits must pay toward their benefits — $25 per month if their income is between 185 percent and 225 percent of the federal poverty level, or $35 for all incomes up to 300 percent.

Without the extra federal funding and maintenance-of-effort requirements in the ARRA and health reform laws, it is likely that more states would have cut back coverage to cope with budget pressures.  Two states — Arizona and New Jersey – did make reductions that were not subject to the laws’ requirements.

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