Finding 4 (Chapter V): Medicaid and CHIP programs worked as intended to provide an insurance safety net for low-income children, especially during times of economic hardship.
Analysis of enrollment data from the 10 study states for a five-year period shows that enrollment in both Medicaid and CHIP grew steadily from 2007 to 2012, with the strongest growth in 2009, the second year of the recent recession. Enrollment growth was driven primarily by increases in Medicaid, which is by far the largest program, covering roughly 80 percent of all publicly insured children during the five-year period.
Medicaid and CHIP play an essential role in ensuring that low-income children have health insurance, and enrollment trends demonstrated a counter-cyclical safety-net system working as intended. The first year of the recent recession (2008) coincided with the largest increases in CHIP enrollment; as higher income families faced unemployment and cuts in employer sponsored coverage, families turned to CHIP programs for coverage. As the economy continued on its downward trend and family incomes continued to drop, new enrollment in Medicaid began to spike and disenrollment in both programs fell, with the greatest increases in Medicaid enrollment occurring in 2009 and 2010.