As of October 2024, three states (New Mexico, Oregon, and Washington) were implementing a new policy that retains children in Medicaid and the Children’s Health Insurance Program (CHIP) up until age 6, regardless of changes in family income, without the need to undergo annual eligibility redeterminations. Several other states have similar proposals under development.

WHY THIS MATTERS

Continuous eligibility policies hold promise for reducing insurance gaps, which could offer more peace of mind to parents, increase families’ financial stability, promote receipt of medical care during a critical developmental period of children’s lives, and improve kindergarten readiness, all of which could lead to better health and well-being in the long term. However, it is essential that families with young children are aware of the policy and can access comprehensive, high-quality, developmentally appropriate primary and specialty care and supportive services that are culturally appropriate. Ensuring the successful implementation of continuous eligibility policies in the pioneering states is important for promoting children’s health and laying the groundwork for other states considering the policy.

WHAT WE FOUND

We identified actions state Medicaid programs, managed care plans, and providers should consider to maximize the potential positive impacts of continuous eligibility policies on children and their families in the following five areas:

1. Ensure that eligibility systems are updated and functioning correctly and that staff are trained in the new policies.
2. Inform and educate families about continuous eligibility policies and maintain regular contact.
3. Engage managed care organizations, providers, community-based organizations, and other state agencies in outreach, education, and assistance to families.
4. Leverage managed care contracting and oversight to support access to high-quality care and prioritize opportunities to improve health outcomes.
5. Monitor implementation in real-time and use the information to course correct.

HOW WE DID IT

In July and August 2024, we conducted interviews about policy and practice changes that could support the implementation of multiyear continuous Medicaid/CHIP eligibility for young children with 29 experts, including child advocates, Medicaid policy experts, federal and state policymakers, health care providers, health plan representatives, and Medicaid researchers.