Arkansas misses out on bonus funds for ARKids First: Time to cut the red tape!

This week, 15 states received more than $200 million in bonuses for enrolling eligible children in Medicaid.  Roughly two-thirds of uninsured children nationally are eligible for Medicaid, which is also the case here in Arkansas.

The Children’s Health Insurance Program Reauthorization (CHIPRA) of 2009 included these bonuses for states that significantly increased enrollment among already-eligible kids.   This year states received between $2.6 million (Kansas) and $55 million (Alabama).

So why did Arkansas miss out? Arkansas is not even eligible to be in the running for an award, even if we were to significantly increase the number of uninsured children enrolled in Medicaid.  States have to adopt at least five changes to make the enrollment and re-enrollment process easier for families to qualify.  To be eligible for a bonus, Arkansas would need to implement at least two of the following changes to ARKids First:

• Expand paperless renewal options:  Right now, families re-enroll their children in ARKids First by submitting a paper form; instead, we can use paperless or “administrative renewal” procedures to verify an enrolled child’s ongoing eligibility for ARKids First. This system would use administrative databases (such as income records in workforce services databases) to determine eligibility when families are renewing.  Louisiana made similar changes in its renewal system and has seen results from it. They now lose less than one percent of enrolled kids from paperwork-related renewal problems, compared with 49 percent of enrolled kids who are lost each year from paperwork problems in Arkansas.
• Offer 12-month continuous coverage for ARKids First A: Under ARKids First B, enrolled children currently keep coverage for a year, regardless of income changes during that year. This ensures that income fluctuations do not disrupt coverage. This same policy should also be applied to children covered under ARKids First A to keep their coverage consistent, too, and avoid the administrative costs of children moving in and out of the system. Twenty-two states offer 12-month continuous coverage for both Medicaid and CHIP programs.
• Start Express Lane enrollment: Case workers can use approved applications from other programs-such as free school lunch applications-to approve ARKids First enrollment, so families don’t have to submit the same information many times to apply for related programs.
• Accelerate enrollment for children who likely qualify: Using trained screeners in schools and community-based organizations, Arkansas can screen applicants and provide immediate coverage to children whose families clearly qualify. If families meet a pre-determined threshold-where it is clear they are eligible ARKids First-the screener could then provide an ARKids First card while the completed application goes to DHS for verification. This process, also referred to as “presumptive eligibility,” allows children to be covered immediately and decreases the chance that a family’s application will fall through the cracks.

The 2011 session would be a good time to make these changes to cut the red tape in ARKids First.  States that have changes up and running by April 1 would be in the running for next year’s round of bonuses.

For more information, see cutting the red tape in ARKids First  or AACF’s child health page.