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Don ’ t Forget CHIPRA! Performance Bonuses & More

Don ’ t Forget CHIPRA! Performance Bonuses & More. National Covering Kids & Families Network Webinar – February 8, 2011 Tricia Brooks. Lots of Good Stuff in CHIPRA: Financing, Coverage, Benefits and Quality. Higher funding levels with many safety valves

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Don ’ t Forget CHIPRA! Performance Bonuses & More

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  1. Don’t Forget CHIPRA!Performance Bonuses& More National Covering Kids & Families Network Webinar – February 8, 2011 Tricia Brooks

  2. Lots of Good Stuff in CHIPRA: Financing, Coverage, Benefits and Quality • Higher funding levels with many safety valves • Explicit authority to cover up to 300% FPL • New CHIP dental benefit requirements, option for stand-alone dental plan • New quality provisions, demonstration projects and reporting requirements

  3. Electronic Match with SSAto Verify Citizenship • Most popular CHIPRA provision • Builds on existing data exchange between states and Social Security Administration • Adopted by 29 states in 2010 • 15 more plan 2011 implementation • Extremely cost-effective and accurate

  4. IL States Adopting SSA Match to Verify CitizenshipJanuary 1, 2011 NH VT WA ME MT* ND MA MN OR NY ID SD WI RI MI CT WY PA NJ IA NE OH IN NV* WV DE IL UT VA MD CO CA* KS MO KY NC DC TN OK SC AR AZ NM AL GA MS TX LA AK FL HI Medicaid and CHIP or Medicaid Expansion Medicaid only CHIP only Plan to Implement in 2011 SOURCE: Based on a national survey conducted by Georgetown Center for Children and Families and the Kaiser Commission on Medicaid and the Uninsured. *Note - CA plans to implement in CHIP; NV and MT plan to implement in Medicaid in 2011

  5. Lifting the 5-Year Bar for Lawfully-Residing Children & Pregnant Women • Also popular CHIPRA provision • Previously, federal funds available only for immigrants in county more than 5 years • Federal help for states using state only funds, but at least seven states expanded coverage

  6. States Adopting Coverage for Lawfully-Residing Children and Pregnant Women January 1, 2011 WA NH VT MT ME ND OR MN MA ID WI SD NY WY MI RI CT IA PA NV NE NJ OH IL UT IN DE CO CA WV KS VA MD MO KY NC DC TN AZ OK NM AR SC MS AL GA TX LA AK FL HI Children Only Both Children & Pregnant Women Waiting for CMS to Approve SPA: PA, IL (both); TX (children only) Pregnant Women Only Source: Based on the findings of a national survey conducted by the Georgetown Center for Children and Families and the Kaiser Commission on Medicaid and the Uninsured, 2011. Note: includes states that have adopted ICHIA in Medicaid, CHIP, or both programs.

  7. Outreach Tools to Enroll Eligible Children • $100 million more for outreach • Outreach proposals due April 18, 2011 for next round of $40 million • National outreach summit • Enhanced match (75%) for translation & interpretation • Connecting Kids to Coverage Challenge • Get in the Game Campaign • Insure Kids Now Website

  8. The Performance Bonus • To reward states for (and help offset the cost of) enrolling low-income children in Medicaid • Two requirements: • Meet certain enrollment targets in Medicaid • Implement at least 5 of 8 measures to increase enrollment and retention

  9. Performance Bonus Calculation • Enrollment targets… • Cumulative annual increases over average monthly enrollment FFY 07, adjusted by % change in child population • +4% in FFY 08, 09 • +3.5% in FFY 10, 11, 12 • + 3% in FFY 13 (ACA ends bonuses in FFY 2013) • Two bonus levels… • Tier 1 = number of children enrolled above target X 15% of state share of Medicaid cost • Tier 2 = Number of children enrolled above 110% of the target X 62.5% of state share of Medicaid cost

  10. Eight Measures to Improve Enrollment and Retention • 12 month continuous coverage • No asset test • No face-to-face interview • Joint applications; comparable procedures • Administrative renewals • Presumptive eligibility • Express lane eligibility • CHIPRA premium assistance

  11. FFY 09 Bonus Awards

  12. FFY 11 Performance Bonus • If legislation is required for a measure, it would have to be enacted by October 1, 2010. • Measure would need to be operational at least 6 months (April 1, 2011) and • remain in effect on September 30, 2011. • Measures must be in place for both Medicaid and CHIP, except premium assistance.

  13. Too Close to Turn Back Now • Children’s coverage has reached a record high >90%. • Nearly two-thirds of uninsured children are currently eligible for Medicaid or CHIP. • Streamlining enrollment and • renewal can help reach these children AND achieve administrative cost savings. • Outreach continues to matter.

  14. Contact Information Tricia Brooks Senior Fellow Georgetown University Center for Children and Families pab62@georgetown.edu http://ccf.georgetown.edu/ http://www.theccfblog.org/ 202-365-9148

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