Youth Justice


February 4th marks the second anniversary of the Child Health Insurance Program Reauthorization Act (CHIPRA), which has already helped many states make significant improvements in health coverage for children. The U.S. Department of Health and Human Services has just issued a new report highlighting many of the gains made in enrolling eligible, but uninsured children in health coverage. During fiscal year 2010, children’s enrollment in Medicaid and CHIP increased by more than two million! About two-thirds of all uninsured children are already eligible for Medicaid or CHIP but are not enrolled due largely to bureaucratic barriers and administrative red tape. CHIPRA addressed those barriers. For example, it included performance bonuses to encourage states to simplify their enrollment procedures and meet targets for enrolling the lowest income children. These incentives have helped children. Even while facing serious state budget deficits in 2010, nearly all states were able to preserve or make improvements in their Medicaid and CHIP eligibility rules and enrollment procedures for children.

More than half the states improved their procedures to verify citizenship status and three states (Colorado, Kansas, and Oregon) expanded income eligibility levels for children in 2010. Six states expanded coverage to lawfully-residing immigrant children and pregnant women during their first five years in the country.

In addition to bonuses for states that improved their enrollment procedures and covered more children, CHIPRA also made grants available to states, community-based organizations, health centers, and faith-based organizations to conduct enrollment and outreach activities. As a result, governments and organizations across the nation are making important strides in ensuring that children eligible for health coverage get and keep it.

To celebrate CHIPRA’s anniversary, the U.S. Department of Health and Human Services is highlighting best practices in outreach and enrollment on their Web site. The Children’s Defense Fund-Texas (CDF-TX)’s collaboration with Fiesta Mart, Inc. is one of those best practices. For ten years CDF-TX has partnered with Fiesta Mart, Inc., a Houston-based chain of neighborhood grocery stores, to hold and promote regularly scheduled children’s health insurance sign-ups that have helped the parents of more than 25,000 children apply for CHIP and Children’s Medicaid programs. These one-day campaigns are held at supermarket locations across Houston and targeted in areas with high numbers of uninsured families. The enrollment drives are publicized through the grocery stores, local media outlets, and materials distributed to parents through local schools. During each event CDF-trained volunteers, state contracted community-based outreach organizations, and representatives from local CHIP and Medicaid health plans are on site to provide application assistance. CDF-TX has also been able to engage a number of other community partners like the Texas Department of Health and Human Services, Harris County Hospital District, the Better Business Bureau, Houston Apartment Association, Gulf Coast CHIP Coalition, many local nonprofits, and area high school, college, and medical students. Together they’ve made a big difference for local children.

Through a partnership with the Texas Association of School Administrators (TASA), CDF’s All Healthy Children Campaign in Texas also works with school districts across the state to help them determine which students are uninsured by adding a question about coverage status to school enrollment forms. CDF then works with school administrators to follow up with parents of uninsured children to help them connect to health coverage. CDF-Texas’s school-based child health outreach has previously been recognized by the American Association of School Administrators, America’s Promise Alliance, the Anti-Defamation League, the Robert Wood Johnson Foundation’s Covering Kids & Families, Texas Association of Partners in Education, and Leadership Houston, which honored CDF-Texas with its Leadership in Action award in 2009.

We are so proud CDF-Texas has been recognized for their important work and ongoing success in connecting children to health coverage. We must work together to continue and expand activities like these around the country until the promise of health reform is realized and every eligible child is enrolled in health coverage.

For more information on CDF’s All Healthy Children Campaign to get more children enrolled in CHIP and Medicaid, please visit our website. To learn more from the Department of Health and Human Services, please visit