Databases for Estimating Health Insurance Coverage for Children A Workshop Summary (2010) / Chapter Skim
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2 The Changing Policy Context
2 The Changing Policy Context
Pages 7-13
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From page 7... ...
Since its passage in 1997 as part of the Balanced Budget Act, the goal of the program has been to close coverage gaps facing low-income families who do not have access to affordable private coverage for their children but do have incomes too high to qualify for Medicaid. These legislative and programmatic goals have created a need for good measures of insurance coverage for children.
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From page 8... ...
CHIPRA included new outreach and enrollment grants and bonus payments to states that adopted five of eight enrollment/retention strategies and that experienced Medicaid enrollment that exceeded targeted growth rates.1 States were also given greater options to use "express lane" eligibility strategies to facilitate eligibility determination and enrollment and were given new options for meeting documentation requirements. CHIPRA allowed states to use federal dollars to cover legal immigrant children who had been in the United States less than 5 years (previously coverage for such children had to be funded exclusively with state funds)
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From page 9... ...
includes enhanced matching rates to states that maintain their Medicaid eligibility thresholds for children and adults, in an effort to induce them to continue supporting Medicaid coverage during the current recession. The enhanced matching rates, which are at least 6.2 percentage points higher than regular matching rates, were implemented on October 1, 2008; they are slated to continue through June 2011, with a phased-down increase in the matching support.
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From page 10... ...
As noted earlier, PPACA includes a technical correction that also refers to definition of a "high-performing state" -- one that "on the basis of the most timely and accurate published estimates of the Bureau of the Census, ranks in the lowest 1⁄ 3 of States in terms of the State's percentage of low-income children without health insurance." The federal matching payment is determined in part on whether a state meets this benchmark. EVOLVING CRITERIA FOR STATE FUNDING ALLOCATIONS Throughout its history, CHIP has relied in some way on estimates of children's insurance coverage, mainly in regard to establishing the amounts allotted to the states for program operations and evaluation.
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From page 11... ...
Under CHIP, this alternates with each fiscal year; that is, the allotment increase factor is applied against the previous fiscal year's allotment or the previous fiscal year's expenditures. COVERAGE ESTIMATES FOR PROGRAM PURPOSES Concerned over the estimate by the Urban Institute that some 5 mil lion eligible children remained unenrolled a year after enactment of the CHIPRA legislation (based on data from CPS and the CHIP State Enrollment Data System)
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From page 12... ...
Similarly, CHIPRA provides matching funds for translation and interpreter services, another focus of data to help target intervention strategies. Mann also identified a wish list for data to assist in managing and evaluating CHIP.
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From page 13... ...
These detailed data would answer questions about different patterns of care around the country and different levels of access to certain providers and to certain protocols. • More standardization of state administrative data and better inte gration of federal and state data collection systems.
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