Reaching Uninsured Children

Iowa's Income Tax Return and CHIP Project

In 2008, Congress passed the Children's Health Insurance Program Reauthorization Act (CHIPRA), which included financial incentives for states to increase outreach and maximize enrollment for eligible, uninsured children. Despite extra efforts by states, several million children who are eligible for Children's Health Insurance Program (CHIP) and Medicaid remain uninsured, suggesting that traditional outreach methods are not enough to reach all children eligible for public insurance programs.

The State Health Access Reform Evaluation (SHARE), a Robert Wood Johnson Foundation program, released a report that examines an innovative approach tested in Iowa—specifically the modification of tax forms to include a question about the health coverage status of each dependent child. The report finds that collecting health coverage information on income tax returns can help to better identify pockets of uninsured children, allowing states to more effectively target outreach efforts and ultimately boost enrollment. This nontraditional approach could be a key learning for others as future CHIP federal funding allocations will be based on states' net enrollment change.

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