MCHbest. NPM 15: Continuous and Adequate Insurance
Approach. Support the enrollment of children in the Children’s Health Insurance Program (CHIP) across the state.
Overview. The Children’s Health Insurance Program (CHIP) is a public benefits program exclusively for uninsured children whose family income is too high for Medicaid. CHIP, financed jointly by the federal government and individual states and administered by the states, insures over 8 million children.1 The Patient Protection and Affordable Care Act of 2010 (ACA) contains provisions to strengthen coverage for children under CHIP, including requirements to conduct outreach and enrollment of vulnerable populations including children and youth with special health care needs. (View policy paper: Affordable Care Act and Children with Special Health Care Needs).
Evidence. Expert Opinion/Field Generated. The Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs (CYSHCN) has identified this strategy as an innovative strategy. Read more in their practice report.
Target Audience. State.
Outcome. Percent of children, ages 0 through 17, who are continuously and adequately insured. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. Access descriptions of ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. You can use these ESMs to see how other Title V agencies are addressing the NPM.
- New Jersey operates a CHIP program called New Jersey Family Care for children in families whose income is up to 355% of the FPL. Premiums are required for those over 200% of the FPL, with a maximum premium rate of $133 per family, per month. At 355% of the FPL, the income eligibility ceiling for New Jersey Family Care is higher than the ceiling for most CHIP programs.
Sample ESMs. Using the approach “Support the enrollment of children in CHIP across the state,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4):
1 Catalyst Center/National Center for Health Insurance and Financing for Children and Youth with Special Health Care Needs. CHIP Financing Strategy.