Getting Every Kid Covered – Learning from Cities’ Enrollment Successes

By Ben Kerman, Head of Strategic Learning and Evaluation

Each year in the first full week of April, we celebrate National Public Health Week, a week dedicated to improving the health of the country and protecting the well-being of our children and future generations. As we celebrate National Public Health Week 2016—a time to think critically about what we can do to make every American healthier—it is impossible to overlook that many low-income Americans, including over 4 million children, remain uninsured and lack access to quality affordable health care.

Partly due to the success of the Affordable Care Act, uninsured levels are at historic lows. But in states like Florida, Georgia, and Texas, the percentage of uninsured children who are eligible for Medicaid, the Children’s Health Insurance Program (CHIP), or marketplace coverage remains high—above the national average of 11.7%. That means there are a few children in each and every classroom whose families cannot afford to address their physical or mental health needs, compounding barriers for those children to succeed socially, academically, and economically.

Reaching these children can be complicated, but there are proven outreach tactics on the municipal level that can successfully increase enrollment. With support from Atlantic’s KidsWell initiative, the National League of Cities (NLC) gave funding to eight cities to help build creative, effective enrollment campaigns to get more children and families insured. As this video from our partners at Mathematica shows, cities benefited from shared knowledge about best practices, and their residents benefited from the promotion of direct, one-on-one enrollment assistance.

Working collaboratively with partners across their cities and around the country, local staff worked to reach families where they were—at the laundromat or an annual city-wide parade, out shopping around Christmas, at food drives, and at other local gatherings where uninsured families are likely to be. NLC offered staff in each city access to best practices and opportunities for peer learning, and the cities implemented creative and locally-driven outreach programs. For example, “Health Access Kids New Bedford” partnered with public schools and recreation centers to target eligible but not enrolled children; Hattiesburg has mobile Medicaid and CHIP “hotspot” enrollment sites at public housing complexes and permanent enrollment sites at a WIC center, the county health department, and a Salvation Army community center; and Providence worked with youth-based organizations to create peer-led outreach efforts. Over the course of this initiative, more than 16,000 uninsured children and parents in the eight U.S. cities participating in the program gained or renewed access to affordable, quality health care.

A closer look at the successes of enrollment campaigns illustrates the importance of state-based advocacy work to address enrollment challenges. An evaluation of Atlantic’s KidsWell campaign by Mathematica found that grantees reported coalition building and direct contact with elected officials as their most effective activities for securing policy advances for children’s health care coverage.

As a country we’ve seen impressive progress on the number of people insured. More people than ever can see a doctor for a sprained ankle, take their baby to the ER with a fever, or get access to important vaccines and preventative treatments, without eating into their grocery budgets or taking out loans to pay hospital bills. There is success to celebrate, but much work remains. More children with access to affordable medical care means more children in school, fewer missed days of work for parents, lower medical costs for families and communities, and a healthier nation.

While each city and state has its own political context and local challenges, we know that we need data-driven, broad-based strategies that work when it comes to effective outreach campaigns to enroll more children in Medicaid and CHIP. Jurisdictions across the country can learn from the work in these eight cities and implement their own successful enrollment campaigns.

For funders, the lesson is clear: these city advocacy efforts are worthy of support. By supporting infrastructure to assess community needs and build strong partnerships, we can get every child access to the health care they need and deserve.

Manatt Health Solutions, Mathematica Policy Research and National League of Cities Institute are Atlantic grantees.