Sec. 2. Findings

279 words·~1 min read·/bill/113/hr/1698/ih/section-2

A research copy — for the controlling text, always check the official state or federal source. Not legal advice.

Congress finds the following: Every year millions of people are enrolled in Medicaid and the Children’s Health Insurance Program (in this section referred to as CHIP ), but subsequently lose their coverage, despite still being eligible, because of inefficient and cumbersome paperwork and logistical requirements. Data show that the typical enrollee receives Medicaid coverage for about three-quarters of a year. Coverage periods are lower for non-elderly, non-disabled adults than for those with disabilities, seniors, and children.

Medicaid enrollees with coverage disruptions are more likely to be hospitalized for illnesses like asthma, diabetes, or cardiovascular disease that can be effectively managed through ongoing primary medical care and medication, are less likely to be screened for breast cancer, and may have poorer cancer outcomes. Children enrolled in CHIP also experience disruptions in health coverage and care. For example, during just a one-year period, over one-third of CHIP enrollees were also enrolled in a State’s Medicaid program.

Transitions between Medicaid and CHIP can cause disruptions in care because the health care coverage and participating providers vary between the two programs. Interruptions in coverage can impair the receipt of effective primary care and lead to expensive hospitalizations or emergency room visits. Unnecessary enrollment, disenrollment, and reenrollment in Medicaid and CHIP result in higher administrative expenses for re-enrollment and result in more people uninsured at any given time.

Stable coverage under Medicaid and CHIP lowers average monthly medical costs. Continuous enrollment also permits better prevention and disease management, leading to fewer serious illnesses and hospitalizations. Children with stable coverage are less likely to have unmet medical needs, allowing children to receive the preventive care that is necessary to help them grow into healthy adults.