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In addition to those three and Texas and Florida, the other states that broadened eligibility for children in Medicaid are Alabama, Arizona, Arkansas, Delaware, Georgia, Kansas, Mississippi, Nevada, North Carolina, North Dakota, Oregon, Pennsylvania, Tennessee, Utah, West Virginia and Wyoming. Eleven of these states expanding kids’ coverage opted against expanding it for adults, after the Supreme Court gave them that option.
Many Kids Shifted From CHIP
In most of those states, between half and two-thirds of the children joining Medicaid were previously covered by CHIP. About 562,000 children were expected to shift from CHIP to Medicaid as a result of the law, according to a study by the Georgetown Center for Children and Families.
Experts say the benefits are generally richer in Medicaid. For instance, families had to pay monthly premiums for their kids’ CHIP coverage in six states that expanded Medicaid for children —Alabama, Arizona, Delaware, Florida, Georgia and Utah, according to Joan Alker, executive director of the Georgetown program.
“Having [to pay] premiums depresses enrollment” in CHIP, she said.
Medicaid requires that children receive comprehensive services, including physical exams, immunizations, laboratory tests and dental, vision, and hearing services. CHIP benefits are not as broad in some states.
Still, state officials and advocates in California and Pennsylvania worry that families may have to find new doctors for their kids because Medicaid does not have as many participating providers as CHIP in some places.
“It’s a mixed bag, as Medicaid has lower costs but possibly fewer providers,” said Kelly Hardy, senior director of health policy for the California advocacy group, Children Now.
But Hardy said the expansion makes life easier for parents who will no longer have to deal with having one child in CHIP and another in Medicaid because income eligibility varied by age. Siblings in different programs might have different benefits, provider networks and cost-sharing.
Unlike Medicaid expansion for adults, the federal government is not paying the full cost of expanded eligibility for the first three years. Instead, states will get the higher federal matching rate for CHIP—about 71 percent of the costs.
‘Welcome Mat’ Effect
In Texas, nearly 2.9 million children were signed up for Medicaid as of August 2014—up about 254,000 school-age kids from December 2013. In the same period, Texas’ CHIP enrollment fell by nearly 160,000.
“There is no doubt we are seeing a welcome mat effect,” involving children who were previously eligible but not enrolled and who were signed up because of the publicity about the ACA’s open enrollment, said Dunkelberg of the Center for Public Policy Priorities.
In Florida, enrollment of school-age children in Medicaid rose by 137,000 this year, which included more than 62,000 kids who transferred from the state’s CHIP program, according to Florida Healthy Kids Corp., the nonprofit that runs CHIP in the state. That switch saved families money, since they previously had to pay a $15- or $20-a-month premium for CHIP coverage.
source : Texas and Florida Expand Medicaid – For Kids
