HealthWatch: Child Health Plus Enrollment

The Curve Bends Back Up, Sharply

Author/Editor: Lee Partridge and Misha Sharp

(Note: A printer-ready pdf of this data brief is at the bottom of this page.)

Having health insurance is critically important for children’s health. Uninsured children are much less likely than those with health insurance coverage to receive recommended preventive care or appropriate treatment for chronic conditions. And these may have long-term consequences for health and economic well-being as these children grow into adults. For nearly 30 years, New York State has helped lower-income families afford health insurance coverage for their children through the state’s Child Health Plus (CHP) program. This has helped reduce the children’s uninsured rate in New York from 12% in 1997 to approximately 2% in 2016. Since Congress passed the federal Children’s Health Insurance Program (CHIP) in 1997, substantial federal funds have been available to support the cost of New York’s program ($526.5 million in FY 2016), along with other states’ coverage programs for children. In September 2017, however, that federal funding will end unless Congress acts to extend it. The gravity of this funding uncertainty is accentuated by the surprising rise in CHP enrollment in every county in New York over the past year, resulting in a statewide jump of 17% between July 2016 and July 2017 (Figure 1).

Figure 1. CHP Enrollment Growth in New York State from 2016 to 2017, by County

Note: To visualize geographic differences in ratios, the Jenks optimization method was used to create the “natural breaks” groupings in Figure 1. Natural breaks are based on the distribution of data values, identifying groups with similar values and setting boundaries where there are relatively large differences. 

http://pro.arcgis.com/en/pro-app/help/mapping/symbols-and-styles/data-classification-methods.htm

 

Over the past ten years the monthly enrollment in CHP has fluctuated, rising from 365,005 in July 2008 to 411,066 in July 2011 and then declining steadily over the following four years to a low of 276,881 by July 2015 (Figure 2). The growth from 2008 to 2011 is generally attributed to the recession, and the decline from 2011 through 2015 to an improving economy and changes in federal Medicaid eligibility policy that resulted in some children and adolescents being eligible to enroll in Medicaid rather than CHP. In May 2016, however, monthly enrollment started to rise again, and it increased steadily every month thereafter to 347,855 by July 2017 (Table 1). It is not clear what precipitated this marked jump in enrollment, but one factor may be the implementation of New York’s new Basic Health program, the Essential Plan, beginning in the winter of 2016. The Essential Plan offers coverage to adults  who are ineligible for Medicaid coverage and whose family incomes are less than or equal to 200% of the federal poverty level. Although children are not eligible for coverage under the Essential Plan, the outreach effort accompanying its launch may have reached families unaware of the availability of CHP.

Figure 2. CHP Enrollment by New York State Region, July 2008 to July 2017

New York State Regions were compiled using New York counties as follows: NYC: Bronx, Kings, New York, Queens, and Richmond. NYC Metro Area: Nassau, Rockland, Suffolk, and Westchester. Upstate Urban: Albany, Broome, Chemung, Dutchess, Erie, Monroe, Niagara, Oneida, Onondaga, Orange, Putnam, Rensselaer, Saratoga, Schenectady, and Tompkins. Upstate Rural: Allegany, Cattaraugus, Cayuga, Chautauqua, Chenango, Clinton, Columbia, Delaware, Essex, Franklin, Fulton, Genesee, Greene, Hamilton, Herkimer, Jefferson, Lewis, Livingston, Madison, Montgomery, Ontario, Orleans, Oswego, Otsego, Schoharie, Schuyler, Seneca, St. Lawrence, Steuben, Sullivan, Tioga, Ulster, Warren, Washington, Wayne, Wyoming, and Yates.

 

After September 30th, under federal law, New York will be permitted to draw down any unspent federal funds from prior years to fund CHP, but state officials project that these funds will be exhausted by early 2018. Ready access to comprehensive, consistent health care is central to ensuring that children receive the support they need to develop into healthy adults. New York’s commitment to CHP over the years has enabled hundreds of thousands of children to have that access. Whether or not Congress approves new CHIP funding, at what level, and for how long will all have major implications for the future of CHP and for nearly 350,000 current CHP enrollees and their families.

Table 1. CHP Enrollment and Percent Growth in New York State by County, July 2016 and July 2017

County

July 2016

July 2017

Percent

Growth

Statewide

297,390

347,855

17.0%

Albany

2,863

4,971

73.6%

Rensselaer

1,698

2,772

63.3%

Schoharie

348

539

54.9%

Columbia

871

1,306

49.9%

Allegany

406

607

49.5%

Schenectady

2,247

3,299

46.8%

Saratoga

2,942

4,288

45.8%

Greene

622

868

39.5%

Rockland

8,900

11,752

32.0%

Livingston

796

1,051

32.0%

Montgomery

908

1,192

31.3%

Fulton

986

1,282

30.0%

Washington

1,298

1,687

30.0%

Chenango

722

937

29.8%

Orange

7,018

8,864

26.3%

Sullivan

1,194

1,508

26.3%

Tioga

621

781

25.8%

Monroe

10,365

12,985

25.3%

Warren

1,199

1,499

25.0%

Genesee

850

1,051

23.6%

Delaware

526

648

23.2%

Dutchess

4,349

5,334

22.6%

Cortland

820

1,005

22.6%

Westchester

13,233

16,138

22.0%

Jefferson

1,542

1,871

21.3%

Cattaraugus

926

1,120

21.0%

Orleans

676

814

20.4%

Madison

1,051

1,259

19.8%

Ulster

3,115

3,691

18.5%

Seneca

478

564

18.0%

Essex

668

786

17.7%

Ontario

1,938

2,280

17.6%

Oneida

3,863

4,533

17.3%

Erie

9,238

10,690

15.7%

Yates

411

475

15.6%

Chemung

782

901

15.2%

Queens

43,141

49,653

15.1%

Schuyler

265

305

15.1%

Oswego

2,076

2,370

14.2%

Otsego

1,018

1,161

14.0%

Onondaga

6,693

7,616

13.8%

Kings

42,015

47,719

13.6%

Richmond

5,978

6,783

13.5%

Niagara

2,752

3,118

13.3%

Wyoming

727

822

13.1%

Nassau

26,336

29,562

12.2%

Bronx

15,784

17,699

12.1%

Herkimer

1,482

1,657

11.8%

Broome

2,447

2,729

11.5%

Lewis

695

775

11.5%

Clinton

1,295

1,442

11.4%

New York

8,284

9,214

11.2%

Hamilton

77

85

10.4%

Cayuga

1,350

1,475

9.3%

Suffolk

34,090

37,237

9.2%

Franklin

650

708

8.9%

Chautauqua

1,603

1,745

8.9%

Steuben

1,330

1,444

8.6%

St. Lawrence

1,587

1,692

6.6%

Wayne

2,145

2,285

6.5%

Tompkins

1,268

1,325

4.5%

Putnam

1,832

1,886

2.9%

Copyright: 2017
Published: 09.28.2017

 

Downloads:

T T T
 
 

Upcoming Events

Family Caregiving

Resources for family caregivers and health care providers are available at our Next Step in Care website.

Support the Fund

The Fund's work is made possible by generous contributors like you. Your contribution helps us make a critical difference.