Children’s enrollment in Georgia Medicaid and PeachCare shows drop

Georgia’s Medicaid and PeachCare programs covered 20,000 fewer children at the end of 2018 than the year before, a new report says.

That 1.6 percent drop is less than an overall 2.2 percent decline in enrollment nationally, according to the Georgetown University Center for Children and Families. The report, released Thursday, said that nationally, about 828,000 fewer children were enrolled in Medicaid and the Children’s Health Insurance Program (CHIP), which in Georgia is called PeachCare for Kids.

Not every child cited in the statistics is now necessarily without coverage. With unemployment low, many less affluent people have been able to find work. So some children may have moved to private insurance as their family income increased beyond the eligibility limits for the two government programs.

Nevertheless, “there are clearly other factors at play, and they are putting children at risk,” said Tricia Brooks, the lead author of the Georgetown report, in a statement. “The federal government took several steps that undermined enrollment, including cutting outreach and consumer assistance funding to help families. Proposed immigration policies have kept many eligible families from seeking or renewing coverage for their children.”

A drop in child enrollment in Medicaid and CHIP is unusual, the report said. Between 2000 and 2016, enrollment decreased in only one year — 2007 — by 1.1 percent. During this period, the nation achieved historic success in covering children, with the rate of uninsured children reaching an all-time low of 4.7 percent in 2016.

“What needs to be determined is what happened to the 20,000 in Georgia,’’ said Erica Fener Sitkoff, of the advocacy group Voices for Georgia’s Children. Last fall, she noted, a report found the number of uninsured children in Georgia rose by 21,000 in 2017, mirroring a national trend She said that Georgia can continue to reduce barriers to kids having insurance, including by improving enrollment processes and extending continuous eligibility in Medicaid to 12 months from six months.

Health insurance coverage improves children’s access to well-child visits, immunizations and prescription drugs. Uninsured children “will not have the access they need to preventive care and well visits,’’ Fener Sitkoff said. “They have to wait much longer when they do need care.’’ Children without coverage are more likely to have unmet health needs and lack a usual source of care.

The Georgetown report found that the declines in child enrollment in Medicaid and CHIP were concentrated in seven states – California, Florida, Illinois, Missouri, Ohio, Tennessee, and Texas – which accounted for nearly 70 percent of the losses.

Nine states – Idaho, Illinois, Maine, Mississippi, Missouri, Ohio, Tennessee, Utah, and Wyoming – had decreases of more than double the national average.

“The fact that nearly one million children in 38 states lost Medicaid and CHIP coverage is very alarming,” Joan Alker, executive director of Georgetown University center, said in a statement. “This report puts federal and state policymakers on notice that the success the U.S. has achieved on children’s health coverage is in jeopardy.’’ In September, the U.S. Census Bureau will release the 2018 data on the rate of uninsured children. That’s when the significance of the enrollment decline will come into better focus, said Bill Custer, a health insurance expert at Georgia State University.

The Georgetown report data, he said, “could be a statistical blip,’’ or reflect kids moving to private insurance, or could be a sign of barriers to enrollment in some states.

The original report:

Medicaid and CHIP Enrollment Decline Suggests the Child Uninsured Rate May Rise Again

Executive Summary
There is no debate over the fact that children are losing Medicaid and Children’s Health Insurance Program (CHIP) coverage. Overall, more than 828,000, or 2.2 percent, fewer children were enrolled in Medicaid and CHIP, combined, at the end of 2018 than the previous year.1 2 A drop in child enrollment is unusual; between 2000 and 2016, enrollment declined in only one year—2007—by 1.1 percent.3 During this period, the nation achieved historic success in covering children with the rate of uninsured children reaching an all-time low of 4.7 percent in 2016. In 2017, child enrollment in Medicaid and CHIP was basically flat while the uninsured rate for children increased for the first time in a decade to 5 percent despite the strong economy.4

The decline in children’s enrollment in Medicaid and CHIP reinforces serious concerns that this alarming trend could continue—and perhaps even worsen. At a time when the economy is strong, the critical question is whether these children are moving to private coverage or becoming uninsured—a question that will not be answered definitively until the U.S. Census Bureau’s American Community Survey data become available this fall.

Introduction
In 2018, enrollment in Medicaid and CHIP declined by 912,000 children in 38 states while only 13 states experienced gains in enrollment. Despite a strong economy, there is negligible evidence that any significant economic factors have substantially increased access to affordable private or employer-sponsored insurance. It appears that both national and state-specific factors played a role in the decline.

While enrollment growth slows during periods of economic growth, it is uncommon for there to be an actual decline in enrollment. The 2018 decline follows the first year in a decade that the number of uninsured children increased, rising by 276,000 children. The uninsured rate rose from 4.7 percent to 5 percent, both statistically significant increases. If health insurance coverage trends continue, the rate of uninsured children is likely to grow again.

This paper examines the significant decline in children’s combined enrollment in Medicaid and CHIP during 2018 reported in federal/state administrative data; what may be happening to coverage for these children; and why it occurred. Most importantly, we describe what can be done to regain the country’s momentum in providing health coverage to children and ensure that eligible children are not losing access to the health care they need to succeed in school and in life.

Full Report and Executive Summary
Read the full report and executive summary.

https://ccf.georgetown.edu/2019/05/28/medicaid-and-chip-enrollment-decline/

I can’t post the full report link from my tablet but it is easily accessible here.

The nearly 1 million decline is actually 912,000 in 38 states and a 84,000 increase in 13 states for a total decline of only 828,000, significantly less than the 1 million cited.

People are having less babies. The question is which people?
Are medicaid/CHIP moms having less babies? Or is it privately insured? or is it the uninsured? Or who?

There are people in the industry who do not want to ask questions to which they do not already know the answer.

Most children are covered by corpooratist CMOs. Peachcare, Wellcare, CareSource, Amerigroup in Georgia. These CMOs get paid X amount per mom or kid covered. The CMOs make profit when their members do not run up big bills. Many CMO members never go to the doctor.

Of six kids in my family, two days after birth we left the hospital and never saw a doctor again, except I saw a doctor in 1952 there are many CMO members who rarely or never have a claim, even now. I’m sure it would never happen. But hypothetically, what if a CMO was getting paid for kids who never had claims because they didn’t exist? What if a shrinkage is due to someone in the CMO having a conscience, or afraid they will get caught? Just hypothetical, of course.

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