There are also lower-than-expected results for CHIP referrals. As noted, one of the data points PPC has been eagerly waiting for months is how many children who have lost Medicaid coverage successfully transitioned to CHIP (or to the state- based marketplace Pennie™). The DHS data tracker shows that 2% of children who lost Medicaid coverage have enrolled in plans through Pennie™ (and we would expect that number to be small), and 34% of children who lost Medicaid coverage have enrolled in CHIP. While we don’t know whether a child’s family has instead enrolled in private coverage, perhaps through an employer, CHIP remains available to all Pennsylvania families not eligible for Medicaid—regardless of income—who don’t Referrals to CHIP during the unwinding process are lower than expected, with only 1 out of 3 children shifting from Medicaid to CHIP, despite CHIP’s broader eligibility guidelines. otherwise have health insurance. That makes it likely that more than 34% of children who have lost their Medicaid coverage should have a free or low-cost option through CHIP. Although the unwinding process is over halfway completed, the data shows an early picture of what’s happening. With two-thirds of children in the unwinding group still pending, there’s still a long way to go. For more detailed data, refer to the Counties by the Numbers fact sheets, which include these unwinding metrics at the county level.
Continuous Eligibility Policy Late last year, Congress passed a federal requirement for states to implement at least 12 months continuous eligibility for children in both Medicaid and CHIP beginning in January 2024 (previously only available in Pennsylvania for children up to age 4 in Medicaid, but all children in CHIP). Even before this new requirement takes effect, states, having learned from the benefit of keeping children continuously enrolled during the COVID-19 pandemic, are beginning to build upon 12-month continuous enrollment policies to provide multi-year continuous coverage for children. To date, eight states have expanded or are actively seeking approval from CMS for multi- year continuous coverage. They are doing so based on a body of research showing that fewer disruptions in insurance coverage allow young children to maintain access to critical preventative services and necessary treatments to support their healthy development. Individuals with inconsistent Medicaid access receive less and more delayed preventive care, refill prescriptions less often, and have more emergency department visits. Many partners, including child advocates, providers, and childrens’ hospitals are urging DHS to join this momentum in providing continuous eligibility for children
from the time of initial eligibility
determination until they reach age six. We are encouraged by DHS’ initial response and interest in this policy change for young children.
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Health Insurance Trends During the Final Year of the COVID-19 Public Health Emergency
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