Who's Missing Out on Children's Health Insurance?

Sep 10, 2010

By Elizabeth Lower-Basch

A new Health Affairs article  reports the characteristics of uninsured children who appear eligible for Medicaid and CHIP.  On an average day in 2008, an estimated 7.3 million children were uninsured, of whom 4.7 million (65 percent) were eligible for Medicaid or CHIP, but not enrolled.  The appendix provides a deeper analysis with both state-level participation rate estimates for all states, and characteristics data at the state level for some of the larger states.  Estimated participation rates among eligible children range from 55.4 percent in Nevada to 95.4 percent in Washington DC.

The authors note that participation rates are very high among children receiving Food Stamps, and yet about 15% of the unenrolled eligible children are receiving Food Stamps. This provides an estimate of the gains that could be achieved through an Express Lane Eligibility approach, where children are determined eligible for CHIP based on information collected by other government programs. Ruth Kennedy, the Program Director of Louisiana's CHIP program, discussed her state's use of Express Lange Eligiblity in the May 2010 CLASP audio conference, The Public Benefits Boost: New Strategies for Increasing Take-Up

Other groups accounting for significant shares of the uninsured eligible children include citizen children with no citizen parents (17.3 percent), and children who are not living with their parents (12.3 percent).  States may wish to target outreach and enrollment efforts at these populations.


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