Change Happens proposes to reduce the number of children who are eligible for, but not enrolled in Medicaid and CHIP, and improve retention of enrolled children. The services outlined are fundamental evidenced-based strategies targeting the hardest to reach uninsured children and reduce coverage disparities.
The target population for this Connecting Kids to Coverage (CKC) program includes children and pregnant women who are Hispanic and Black/non-Hispanic living in Harris County/Houston, Texas. Harris County is the largest County in Texas with a population of 4,728,030 (US Census, 2020). Houston, located in Harris County, is the largest city in Texas and the 4th largest city in the United States. After years of improvement, the number of uninsured Texans has worsened for the third year in a row, reaching 5.2 million in 2019, meaning 18.4 percent of Texans of all ages were uninsured. This is the worst Texas rate since 2014 and is twice the national average of 9.2 percent (US Census, 2020). After 10 years of enrollment growth, there has been a alarming decrease of 237,000 Texas children enrolled in Medicaid and CHIP,
representing a 7 percent decline between the end of 2017 and February 2020. According to the American Community Survey (2019), 611,560 or 46.1% of children living in Harris County received CHIP or Medicaid.
Estimates of children not enrolled:
An analysis by Every Texan of US Census American Community Survey (2019, 5-year estimate) concludes that there are over 400,000 Texas Children that are eligible for Medicaid or CHIP and not receiving these benefits. Moreover, 59,305 or 12.3% of children in Harris County are uninsured. Change Happens proposed to bridge racial and demographic health coverage disparities by targeting subgroups of children with lower-than-average health coverage rates, Hispanic and Black/non-Hispanic children, and pregnant women.
Barriers to enrollment and retention of target population
A lack of knowledge about Medicaid and CHIP enrollment procedures and perceived enrollment barriers may be an obstacle to enrollment. Moreover, as a result of the COVID-19 Public Health Emergency (PHE), enrollment in Medicaid and CHIP increased. However, as states prepare to and eventually transition back to normal operations when the PHE ends, ensuring that eligible children and Pregnant women retain Medicaid and CHIP coverage is critical. Change Happens will work in partnership with the State and other stakeholders to conduct outreach and provide assistance to beneficiaries needing to renew coverage and to assist applicants that may have been inappropriately terminated and need help to re-apply.