Medicaid Performance Bonuses

12/30/2010 03:01 pm ET | Updated May 25, 2011

For Amanda from Tigard, Oregon, one of the worst things about going without health insurance was worrying that something might happen to her son Jacob when she couldn't afford a doctor. Jacob, now 3, was having vision problems and needed to see an eye doctor.

Fortunately, Oregon has begun taking innovative steps to make sure every child who is eligible for the state's health coverage programs signs up. Because Amanda was already receiving nutrition assistance, the state knew she might qualify for Medicaid as well. They sent her a letter with a very short "Express Lane Eligibility" application that made signing up quick and easy. Jacob was enrolled and he'll be covered in the New Year. "It was very simple to apply," Amanda said. "I'm just very excited I can take Jacob to his eye doctor appointment."

Jacob is just one of nearly 900,000 children in 15 states who have health insurance this year because of their state's efforts to streamline the enrollment process.

As a mom, I know there's nothing more important than knowing your children can get health care when they need it. And as Secretary of Health and Human Services, I've seen how effective programs like the Children's Health Insurance Program and Medicaid can be at giving families peace of mind.

Yet there are about five million children today who qualify for one of these programs but aren't enrolled, either because they don't know they're eligible or because they face unnecessary red tape that makes it difficult to get through the application process.

That's five million children who, like Jacob, are just a few easy steps away from getting the checkups and vaccines they need to stay healthy -- a few easy steps away from giving Moms like Amanda the sense of security that goes along with having health coverage for their children.

The good news is that Oregon and other states have responded with ambitious efforts to find these children and sign them up for health coverage. Earlier this week, our department awarded $206 million in performance bonuses to states that have significantly increased the number of children enrolled in Medicaid and streamlined their enrollment and renewal processes to make it easier for families to sign up.

These bonuses were a key part of the historic Children's Health Insurance Program Reauthorization Act, which President Obama signed last February, making millions more children eligible for coverage and giving states new financial incentives to get and keep kids covered.

In Iowa, Colorado, and Ohio, for example, children who appear eligible can be enrolled in Medicaid or CHIP temporarily -- often at health clinics, schools and other community-based organizations -- while their parents get the time they need to present paystubs or other documents to demonstrate their eligibility. For children with pressing health care needs, getting necessary treatment or medicine right away makes all the difference in the world.

In Wisconsin, families can now submit their coverage applications and renewal forms by mail, by phone, or online -- the kind of flexibility that is so important for working families.

Ten states that received bonuses now guarantee eligible children a full year of coverage so that their families can rely on 12 months of undisrupted care, a significant help to children who need ongoing care for chronic health conditions.

And New Mexico goes even further, sending families renewal forms that include the most recent income information that has been reported by the child's family. According to State officials, prior to the use of this pre-populated renewal form, renewal rates ranged from 40% to 60%. They now have jumped to an average of 80%.

Efforts like these show that small changes to make getting health insurance more convenient can make a big difference. Thanks to these reforms, hundreds of thousands of children will be able to get the health care they need and their families will no longer have to choose between paying a hospital bill and a grocery bill.

We should be incredibly proud of the progress we've seen in the 15 states that met their performance goals and enrollment targets. These states, along with others that have consistently achieved high participation rates, have shown that our goals for children's coverage are realistic. Today, the share of children in America with health insurance is higher than it's ever been before -- a great achievement during tough economic times that have stretched family and state budgets thin.

And yet, we still have significant room to improve.

That's why I've challenged my colleagues in this Administration, our friends in state and local government, and health care providers, community groups, faith organizations, and even sports coaches around the country to work with us to cover the five million uninsured kids who are eligible for CHIP or Medicaid over the next five years.

We don't need to pass any new legislation to get these kids health insurance. We don't need to create any new programs. We just need to find them and sign them up. To learn more about how you can help, I encourage you to visit our great new website

In 2010, we took a big step towards making sure every child in America can get the health care they need. In 2011, we need to keep that momentum going.

MomsRising, one of the first national organizations to step up to Secretary Sebelius' Connecting Kids to Coverage Challenge, is working hard to make sure that families with eligible children know about Medicaid and CHIP and how to apply. This holiday season, MomsRising has been promoting the programs with its new "Give a child the gift of health insurance" web page which provides links to helpful children's health insurance information in both English and Spanish. Efforts like these will help us meet the goal of covering the 5 million uninsured children who are eligible for Medicaid and CHIP but not enrolled.