Children’s Health Insurance Program Reauthorization Act (CHIPRA)

Children’s Health Insurance Program Reauthorization Act (CHIPRA)

The Centers for Medicare & Medicaid Services has awarded performance bonuses to 23 states for improving access to children’s health coverage and successfully enrolling eligible children, CMS Acting Administrator Marilyn Tavenner announced.
The performance bonuses are authorized under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA), one of the first pieces of legislation signed into law by President Obama.  States qualify for a bonus by implementing procedures to simplify enrollment and renewal to ensure that all eligible children have easier access to coverage under Medicaid and CHIP.
They must also exceed targets for enrolling the lowest income children. “States are ensuring more children get the health care they need,” Acting Administrator Tavenner said. “We are proud to reward states that are reducing enrollment barriers and connecting kids to coverage.”
CHIPRA established performance bonuses, giving states an incentive to support enrollment and retention of eligible children in Medicaid and CHIP and helping to defray the costs associated with increasing enrollment of the lowest income children. To qualify for a performance bonus, states must implement at least five out of eight specific program features aimed at streamlining their enrollment procedures to improve children’s health coverage programs and must increase children’s enrollment in Medicaid above a baseline level for the fiscal year. The eight program features include:

  • 12‐month continuous eligibility (Allows full‐year enrollment regardless of income or other changes.)
  • Elimination or reduced verification of asset requirements
  • No requirement for an in‐person interview • Same application and renewal forms for Medicaid and CHIP
  • Automatic/administrative renewal (pre‐populated form; electronic verification used to streamline renewal)
  • Presumptive eligibility (allows health care providers and other entities to screen and presumptively enroll children; children have access to needed benefits while the full eligibility process is being completed)
  • Express Lane Eligibility (States can use eligibility findings from other public benefit programs, such as the Supplemental Nutrition Assistance Program (SNAP) to determine eligibility for Medicaid and CHIP.)
  • Premium Assistance

Studies show that enrollment in Medicaid and CHIP have been driving the nation’s steady progress on increasing the number of children with health insurance coverage.
The 23 states awarded performance bonuses include Alabama, Alaska, Colorado, Connecticut, Georgia, Idaho, Illinois, Iowa, Kansas, Maryland, Michigan, Montana, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, South Carolina, Utah, Virginia, Washington, and Wisconsin. Utah is receiving a performance bonus for the first time; the other states have received bonuses in previous years.