Coverage You Can Count On
Make Medicaid Coverage We Can Count On
Medicaid and CHIP are lifelines for tens of millions of Americans who are low-income, aging, or disabled Americans, providing health care coverage when they need it most. However, these important programs must be further improved to ensure that their coverage is consistent and reliable, and to ensure that Americans can count on these programs when they need them.
Enrollment in Medicaid and CHIP – unlike private insurance or Medicare – has been compared to a leaky sieve; every year millions of people enroll, only to subsequently lose their coverage due to lost paperwork and slight changes in income. These interruptions in coverage, widely known as “churn,” undermine coverage and hurt the continuity and effectiveness of the care these Americans can receive.
Now, bipartisan legislation has been introduced in Congress to address churn and truly make Medicaid and CHIP coverage more reliable. Urge your Member of Congress to support these important initiatives. Read on for more background.
Stabilize Coverage in Medicaid and CHIP
In the House, Representatives Joe Kennedy (D-MA) and John Katko (R-NY) have introduced the bipartisan H.R. 1879, the Stabilize Medicaid and CHIP Coverage Act of 2015. Senator Sherrod Brown introduced S. 873, the companion legislation in the Senate. These bills provide 12-month continuous eligibility for all Medicaid and CHIP enrollees.
What is Medicaid “churn”?
Americans become eligible for Medicaid when their incomes fall below a certain level or they have certain health care issues including disabilities or complications due to aging. Currently, the average Medicaid enrollee is on the program less than 10 months per year. Some enrollees leave the Medicaid program because they become eligible for employer-sponsored coverage or Marketplace coverage. But in many cases, people are kicked off the program because of “churn” — a loss of coverage because of lost or confusing paperwork or short-term increases in income due to overtime pay or working a few extra hours. Losing coverage in these ways is fundamentally unfair AND creates disincentives to earn extra money.
How would the Stabilize Medicaid and CHIP Coverage Act fix “churn”?
By providing 12 months of continuous eligibility in Medicaid and CHIP, the Stabilize Medicaid and CHIP Coverage Act will reduce the number of low-income Americans who lack health insurance coverage and improve the stability, continuity and quality of care they receive. If enacted, this legislation will prevent loss of coverage due to bureaucratic snafus or small amounts of temporary, extra earnings. Health plans and providers in the Medicaid program will also be able to improve continuity of care – particularly important for people with complex chronic illnesses or those suffering from substance use disorders. Stable coverage will also help quality improvement organizations truly evaluate the quality of care that is being provided by health plans and providers and give taxpayers a better understanding of what they are paying for.
In short, the Stabilize Medicaid and CHIP Coverage Act will ensure that Medicaid and CHIP, which together provide coverage to nearly 1 in every 4 Americans, is health care coverage they can count on.
For more information about how unstable coverage affects the millions of Americans who rely on Medicaid and CHIP, review the churn FAQs.
Letters of support from organizations representing health plans, doctors, hospitals, and patient advocates are available here.