CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings. Finding 2 (Chapter III)


Finding 2 (Chapter III): Medicaid and CHIP participation rates increased even as the number of eligible children has grown. The number of children eligible for Medicaid or CHIP yet uninsured fell from 4.9 to 3.7 million, and 68 percent of all remaining uninsured children are eligible for Medicaid or CHIP.

Participation rates show the portion of the eligible population without private coverage that is enrolled, providing an indication of how successful Medicaid and CHIP programs are in reaching their target populations. Nationwide, Medicaid and CHIP participation rates among children increased from 82 percent in 2008 to 88 percent in 2012, and were above 90 percent in 21 states. Over this period, many states implemented changes in their enrollment and renewal processes and adopted new outreach strategies aimed at increasing the take-up and retention of Medicaid and CHIP coverage among eligible children (Heberlein et al. 2013; Hill et al. 2013; Hoag et al. 2013a).

Participation rates increased across all subgroups defined by income, age, race and ethnicity, immigration status, and functional status, and exceeded 90 percent for children under age 6, children with income below 138% percent of the FPL, black non-Hispanic children, non-Hispanic children with multiple or other race, and children with functional limitations. Compared to these groups, rates remained lower for adolescents, non-citizens and children without functional limitations.

The number of children eligible for Medicaid or CHIP yet uninsured fell from 4.9 to 3.7 million between 2008 and 2012 – all the more impressive because 4.5 million more children became eligible for Medicaid or CHIP during that period. As of 2012, an estimated 68 percent of all uninsured children were eligible for Medicaid or CHIP but not enrolled; others were not eligible because of their immigration status (21 percent) or income level (79 percent).

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