11 Tips to Help Children Get Enrolled in Medicaid and CHIP – Say Ahhh! A Children’s Health Policy Blog


By Judy Darnell, United Ways of California

One of United Ways of California’s goals is to improve
the health of children and adults. We know that a lack of health care coverage
often means that primary care is an unattainable luxury. Yet primary care is so
important in preventing or treating illness before it becomes more serious. For
children in low-income families, Medicaid and the Children’s Health Insurance
Program (CHIP) can provide comprehensive, affordable health coverage when their
parents may not have access to health benefits through their jobs or be able to
afford coverage on their own.

Whether you are just getting started or looking to
accelerate long-standing efforts to advance health coverage for children, here
are steps that United Ways across the country are taking to increase our impact
and help us reach our goals. We hope that others can utilize some of these

First steps:

SPECIFICS. Familiarize yourself with your state’s children’s health coverage
programs. Health coverage is available to most low-income children in every
state; however, eligibility requirements, enrollment procedures and
cost-sharing rules vary widely across the country. These and other aspects of
the program will influence the ability of low-income children to secure health
coverage in your state.

Descriptive information about your state’s CHIP and
Medicaid programs and the application processes can be found using this link on
the Center on Budget and Policy Priorities‘ website. 

COALITION PARTNERS. Find out who else is working on this issue- you could start
by engaging local United Ways or your state’s Association of United Ways. Join
an existing statewide or local coalition that is engaged in efforts to reach
out and enroll eligible children. An experienced coalition partner should be
able to add to your understanding of the challenges confronting uninsured
children in your state: Who are they? Where in the state are they most likely
to reside — in urban or rural areas? Are there communities where immigration
status or limited English proficiency present challenges?

Moving Forward:

TRADITIONAL AND NONTRADITIONAL PARTNERS. Engage a wide range of people including
partners with whom you would regularly work and reach out to new partners as
well.  Groups to consider include:
community organizations, elected officials, business leaders, media, clinics,
informal neighborhood leaders, ministers, medical professionals, school
personnel — anyone who has contact or influence in the lives of families who
might need health coverage who will have an interest in enrolling children in
health coverage.  Help these
advocates to identify ways they, and their colleagues, can contribute to
getting more children enrolled.

When engaging partners in outreach and setting goals,
it’s helpful to find out about coverage levels in your state.  Health coverage status and coverage
rates for children and families in your state, can be viewed on the Georgetown
University’s Center for Children and Families website:

HEALTH COVERAGE OUTREACH INTO EVERYTHING YOU DO Be creative!  Are there ways to integrate even a little
outreach into the other work you do? If you are focused on early childhood,
engage your childcare centers and providers in health insurance outreach. If
you are engaged in workforce development, include health outreach assistance in
the resources you provide or coordinate.

would like to be able to offer more benefits. Helping dependent children get
enrolled will fall to their bottom line with healthier kids, less absenteeism
among parents and more loyal employees. Especially partner with those who are
known to employ lower-wage workers. But don’t assume any business covers
dependents!  Share resources to
educate employees about income eligibility and provide employers with outreach
material such as payroll stuffers and posters for break rooms. Your local
United Ways may be particularly helpful with this step, as they regularly
connect with the businesses in their communities.

When working with business leaders to build support,
there are a few key factors to keep in mind:

– Business leaders want and trust data, but only when it
comes from a trusted source that has proven to be reliable. 

– Business leaders need to know how this will affect
them.  The bottom line for some
business leaders is that parents caring for sick kids mean absenteeism among
their employees or reduced productivity affecting their bottom line.  For others, kids who show up to school
sick or are unable to attend at all mean less chance of an educated and fully
prepared future workforce.

– Build a simple, straightforward case that avoids using
health industry jargon with which they may not be familiar.  Back up your case with data on the
success of CHIP and Medicaid.

– Ongoing communication with business leaders helps to
eliminate or alleviate opposition. 
It is not always possible to bring business to a position of support on
children’s health issues, but with consistent education around the importance
of public health programs for kids, an absence of opposition from business
leaders often speaks volumes on its own and is enough to allow policies to move

ELIGIBLE CHILDREN. As a result of the weak economy, many families are
experiencing unemployment and have become uninsured for the first time. Many
parents may not realize their children now qualify for health coverage or know
how to access these vital programs. Promote health coverage sign-up
opportunities where jobless individuals seek assistance including the
unemployment office, job fairs or re-training programs. Target communities
where there have been plant-closings or employers have downsized. Support
“rapid response” activities, during which outreach workers can provide
assistance applying for a host of benefits.

7. USE 2-1-1. 2-1-1
is an easy to remember number available in over 90% of the U.S. that connects
people to services for free.  2-1-1
has proven to be an effective channel for obtaining information regarding
health insurance coverage and care. 2-1-1 call specialists can direct callers
to the most convenient location to get application assistance or in some areas
they may be able to complete the application over the phone.

NEEDS. Identify and address obstacles to enrollment. Increase the likeliness of
success by providing necessary supports including childcare, bilingual and
culturally appropriate application assistance.

You or your partners may also be able to help make
enrollment assistance more efficient by providing laptops, scanners or portable
copiers to assist the enrollment process.


EXPANDING ELIGIBILITY AND BENEFITS. Coalitions who actively urge state
policymakers and program administrators to adopt options made available through
CHIPRA can be particularly effective. Even before all of the provisions of ACA
come into effect, states have the flexibility to increase income eligibility
ceilings, to provide coverage to pregnant women, and provide dental coverage to
children whose private insurance lacks that critical benefit.

ENROLLMENT AND RENEWAL. CHIPRA gives states tools and incentives for
simplifying enrollment and renewal. For example, states can receive a
“performance bonus” if they boost enrollment of children in Medicaid and reach
specified targets. To be eligible for these extra federal funds, the state must
first implement five out of eight strategies that have been shown to facilitate
enrollment and renewal. Advocate with your partners for the state to take steps
to qualify for the performance bonus and then invest in outreach necessary to
meet the enrollment target.

Partner with others and ask that they join in the effort
to advocate for kids coverage. Activities can range from sending lawmakers
and/or program administrators coalition letters, writing op-eds, or even
testifying before a legislative committee.  This resource page will provide you with information about
CHIPRA requirements and options as well as access to the law itself:

YOUR PROGRESS. Ensure that key stakeholders know about your advocacy, outreach
and enrollment work and resources. Communicating about your activities can
attract volunteers, and increase revenue and therefore, enroll more children in
health insurance. Contact your local media. Put up flyers in libraries and
parks. Announce progress in PTA meetings. Create a health coverage page on your
website that includes information on eligibility and how to enroll. Talk about
it at events. Identify potential partners that have informal and formal
communication with families who might benefit.

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