Getting and Keeping Children and Families Enrolled in State’s Health Coverage Programs

by Erin Sloan-Turner, CHIPRA Program Specialist, Michigan Primary Care Association

There are 123,000 uninsured kids in Michigan—enough children to stretch 70 miles if they held hands, fill 2,236 school buses, and form 13,666 little league teams. Decreasing that number through “on the ground”, community-based enrollment was the focus of Michigan Primary Care Association’s work as Cycle 1 CHIPRA grantee.

With tens of thousands of outreach encounters and thousands of children’s health insurance enrollments achieved since our program began in 2009, we’ve learned many things. One of the most important lessons we’ve learned is that direct outreach/enrollment efforts alone, while absolutely critical to success, are not enough to ensure coverage for all of our children.

We realized very early in our work that a significant percentage of the children we were signing-up for Medicaid and CHIP had previously been enrolled. The underlying data confirmed that our anecdotal experience was spot on—in Michigan, 44% of the currently eligible but uninsured were dropped out of Medicaid/CHIP during the previous year. Further examination of the data revealed that while Michigan continues to have one of the best participation rates in the country we’re on the bottom half of the list in retention.

As a Cycle 2 CHIPRA grantee in Michigan, MPCA is working to implement a simple, consistent approach to ensure families understand how and when to renew their children’s coverage, remind families to reapply as their renewal date approaches, and offer assistance with redetermination for families that need help with renewal. MPCA has already implemented both text and voice messaging systems to send renewal reminders to our grant target population of 90,000 Medicaid/CHIP enrolled children, so far we’ve gotten good feedback and strong support from families.

This month, MPCA and Text4Baby began working together with the Michigan Department of Community Health, Michigan’s Health Plans and other key stakeholders to boost enrollment of pregnant women and infants through a number of new strategies including future incorporation of Text4Baby sign-up into our online application for Medicaid and CHIP. The Text4Baby system naturally compliments our focus on getting and keeping kids and families enrolled for as long as they remain eligible and offers our enrollees new supports in establishing positive health behaviors like seeking preventive care and getting immunizations.

Simultaneously, we’re working to integrate Text4Baby messages for Michigan enrollees that offer state-specific coverage and health behavior supports and yearly coverage renewal reminders timed to each enrollees redetermination date similar to those MPCA is using today.

While the work has just begun, the partnership will give us the opportunity to take what we are learning about retention and renewal as a Connecting Kids to Coverage partner and expand the population receiving coverage renewal support in Michigan. It’s another great step forward in our challenge to make sure every eligible child is enrolled, stays enrolled and grows up healthy in Michigan!


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