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States to Get U.S. Bonuses for Covering Uninsured Children

Twenty-three states will share $296.5 million in U.S. payments for encouraging low-income families to enroll their children in public health programs.

Bonuses announced today reward states that streamline eligibility for Medicaid, the federal-state health program for the poor, or the Children’s Health Insurance Program. The effort is aimed at children younger than 19 from households with annual incomes of as much as $45,000 for a family of four, though some states have more generous criteria.

Despite the flagging economy, the number of uninsured children decreased to 5.9 million in 2010 from 6.9 million in 2008, according to a study by the Georgetown University Health Policy Institute in Washington. Children still drop off program rolls because parents don’t renew eligibility, increasing the likelihood of missed vaccinations and dental checkups, said Tricia Brooks, a senior fellow at the Georgetown institute.

“Families may avoid routine preventive care with the hope they’ll have more money next month or delay seeking care until they know they really have to bring the children in,” Brooks said in a telephone interview. “At that point, the emergency room is a likely choice.”

Maryland led states claiming 2011 bonuses with $28.3 million. Virginia was next highest with $26.7 million, followed by Colorado with $26.1 million. Connecticut, Georgia, Montana, North Carolina, North Dakota, South Carolina and Virginia were among first-time recipients for the money, authorized under a 2009 federal law.

Cutting Red Tape

To win bonuses, states took steps such as using electronic databases rather than paperwork submissions from families to verify incomes or presumptively enrolling kids who appear to be eligible. States may also guarantee a year of eligibility instead of requiring periodic renewals.

Georgia and South Carolina use information from their nutrition assistance programs to speed eligibility determinations, said Marilyn Tavenner, acting administrator of the U.S. Centers for Medicare and Medicaid Services, during a conference call with reporters.

Last year, 15 states claimed bonuses totaling about $206 million led by Alabama, which got $55 million after adding 133,000 children to its public insurance programs.

Economic Effects

State-by-state variations and continued tough economic times make any gains fragile, according to scholars studying those without health insurance.

Massachusetts had the lowest rate of uninsured children, while Nevada had the highest, according to the Georgetown study that analyzed data from 2008 to 2010. Florida made the most progress in the three years, cutting the number of uninsured children by 160,824.

States including New York already have eligibility standards above what the bonuses encourage. Children from families earning as much as four times poverty can be signed up for New York’s Medicaid program, according to the nonprofit Kaiser Family Foundation in Menlo Park, California.

The other states to receive bonuses announced today by the Centers for Medicare and Medicaid Services were: Alabama, Alaska, Idaho, Illinois, Iowa, Kansas, Louisiana, Michigan, New Jersey, New Mexico, Ohio, Oregon, Washington and Wisconsin.

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