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Bridging health disparities through Medicaid and CHIP

Monday, March 29, 2021

It’s been nearly two years since the North Carolina Community Health Center Association (NCCHCA) took on the mandate to bridge health disparities in the state by enrolling medically uninsured children into the Children’s Health Program (CHIP) through the Connecting Kids to Coverage grant.

The Connecting Kids to Coverage Program assists families, children, and pregnant women who are below the Federal Poverty Level (FPL). The FPL is a measure of income issued annually by the Department of Health and Human Services. It is used to determine an individual’s eligibility for certain programs and benefits, including savings on marketplace health insurance, Medicaid, and CHIP coverage.

“Health insurance coverage varies dramatically by race. In North Carolina, 36 percent of all uninsured children are Latino,” explains Tamara Jones, the NCCHCA former Coordinator for Connecting Kids to Coverage program in a recent interview. In addition, more than 30 percent of Medicaid eligible parents are uninsured in North Carolina, she says.

“So, the Connecting Kids to Coverage program aims to help bridge those disparities by reaching out to the sub-groups and children that have lower than average coverage rates such as children in rural areas, teens, native Americans, and Hispanics,” she adds. The program also targets hard-to-reach populations, including the homeless. “NCCHCA also provides training focused on reaching these hard-to-reach populations by trying to bridge those health disparity coverage gaps that we’re finding in these sub-groups,” Jones explains.

About 300 families have benefitted from the Connecting Kids to Coverage program. Jones believes this number could be higher because CHCs have on countless occasions assisted people outside of the program’s target population.  Still, not everyone who needs to benefit from the program has benefitted from it either. This is primarily because of the Medicaid and CHIP program requirements. For example, the threshold for working parents in North Carolina is 47 percent of the FPL.

“A parent with two children who earns $ 12,000 makes too much for Medicaid in North Carolina So, you have to have a very low income to be eligible for Medicaid in North Carolina. This makes it very difficult to find eligible parents that meet the requirements for Medicaid and so we found that a lot of them are in that coverage gap,” explains Jones.

This essentially means that most families have an income that’s too high for Medicaid but still too low to even seek health insurance subsidies in the health insurance marketplace. “To receive health insurance subsidies from the marketplace they would have to earn $25,100 to even get assistance so that is what we’re running to a lot with the parents and children that we’re trying to assist,” explains Jones.

To date, 39 states (including DC) have adopted the Medicaid expansion and 11 states have are yet to adopt the expansion. North Carolina is one of 11 states that have not expanded Medicaid. Other states that have not expanded Medicaid include Florida, Georgia, and Tennessee. “ We know that parents who are covered are more likely to have their children covered,” responded Jones when asked if she thinks the Connecting Kids to Coverage program would achieve higher coverage rates if more parents were covered with Medicaid.

A provider sharing information with a parent and her daughter.

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