As the calendar turned to 2024, a milestone arrived in children’s health care. As of January 1st, every state in the U.S. is required to provide 12 months of continuous eligibility for children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP). This means that, for the first time, millions of children will have uninterrupted access to health care coverage and vital medical care, regardless of changes in their family’s income.
Imagine a child battling asthma – relying on inhalers and regular checkups to stay healthy. Now imagine the stress of a family constantly worried about potential lapses in coverage due to income fluctuations or administrative hassles. This was the reality for countless families before the continuous eligibility requirement. Income fluctuations, job changes, or even minor paperwork errors could trigger months-long loss of health care coverage, leading to missed checkups, delayed diagnoses, and untreated health problems for kids.
The new 12-month continuous eligibility requirement stops this revolving door of health care coverage. Children enrolled in Medicaid or CHIP will now be guaranteed health care coverage for a full year, even if their family’s circumstances change. This means:
- Preventive care becomes a priority: Regular checkups, immunizations, and screenings are crucial for early detection and prevention of illnesses. Continuous coverage helps ensure children don’t miss out on these critical services.
- Chronic conditions can be managed effectively: Children with chronic health conditions, such as asthma or diabetes, need consistent access to specialists and medications. The new policy eliminates disruptions, allowing them to stay on track with their treatment plans.
- Mental health receives deserved attention: Access to mental health services is just as vital as physical health care. Continuous coverage empowers families to seek essential mental health support for their children without fear of losing coverage.
The benefits of continuous eligibility extend far beyond individual children. Uninterrupted care strengthens communities by ensuring that all children, regardless of their family’s background, have access to quality health care. This, in turn, reduces the burden on hospitals and emergency rooms, leading to a healthier and more productive population overall.
While this new policy is a cause for celebration, it’s important to remember that ongoing work is needed to ensure all children have access to high-quality health care. This work includes:
- Promoting awareness and outreach: State and local efforts educating families about the new policy and how to enroll their children in Medicaid and CHIP is crucial to maximizing its impact. Community outreach programs, culturally sensitive materials, and clear communication channels are key to ensuring everyone knows about this new policy, as well as how to access health care coverage through Medicaid and CHIP generally.
- Expanding to multiyear continuous eligibility: 12-month continuous eligibility offers a welcome first step, but it does not go far enough in protecting children through some of their most crucial years. Expanding the policy to provide continuous eligibility through age 5 would provide stable access to coverage and reduce the risk that children miss important milestones in their development.
- Addressing disparities in access: Children in low-income families, rural communities, and in certain racial and ethnic groups and immigration statuses continue to face barriers to accessing health care. Congress must continue and expand upon targeted efforts to bridge these gaps and ensure equitable health care for all.
- Investing in provider networks: Expanding provider networks, particularly in underserved areas, is crucial to ensuring that children have access to the specialists and services they need.
The 12-month continuous eligibility policy for children in Medicaid and CHIP is a landmark achievement, a testament to the power of collective action and unwavering commitment to children’s health. It is a significant step toward a more equitable health care system, one where every child has the opportunity to thrive, regardless of their background or circumstances. Let us celebrate this victory while continuing to advocate for policies that prioritize the health and well-being of all children and families.