Medicaid/CHIP Beneficiaries and the 2014 Ward Snapshots
The 2014 Ward Snapshots provide us with updated numbers on child well-being indicators for DC and its eight Wards. It is encouraging to see that changes on most of the indicators are positive for DC children. But it is also debatable whether the changes observed are small given that the reported changes are over a timeline of ten or more years.
The 2014 Ward Snapshots compare how each Ward has fared vis-à-vis other Wards and the overall changes for DC. It helps answer questions like: Has child poverty decreased uniformly across DC or has child poverty decreased in some wards and increased in others? Similarly has the infant mortality rate decreased uniformly across the eight Wards? What about the teen pregnancy rate, Medicaid enrollment, unemployment rate, homeownership rate, etc.?
One interesting observation is the increase in DC’s (under 21) Medicaid and Children’s Health Insurance Program (CHIP) enrollment given the lower child poverty rate and the child population (both under 18) in 2011 than in 2000. One would have assumed the opposite to have happened - that the (under 21) enrollment in Medicaid/CHIP would have decreased given the decrease in the total number of children and children in poverty. But, from 2000 to 2011 the (under 21) enrollment in Medicaid/CHIP increased by approximately 11,000, the child population is estimated to have decreased by approximately 12,000, and the total number of children estimated to be living in poverty fell by 7,000.
There are several potential explanations for this scenario. The largest factor is likely the expanding income eligibility standards in DC for Medicaid/CHIP enrollment. In DC, children from families with income up to 300% of the Federal Poverty Line (FPL) are eligible for health care through Medicaid/CHIP. This broad eligibility standard is an important strength of DC’s social safety net for children. But, in 2000 eligibility only extended up to 200% of poverty. So, while the total number of children in poverty decreased from 2000 to 2011, eligibility for Medicaid/CHIP increased.
Also, a greater percentage of children might now be in families earning between 200-300% of the FPL. Note: In 2011, 300% of FPL would have meant an annual income of approximately $55,590 for a family of three. For 2014, the Medicaid/CHIP eligibility standards for children have been expanded to 319% of FPL.
Another factor could be that DC now does a better job of enrolling Medicaid/CHIP eligible children. As per our policy snapshot on Medicaid/CHIP, in 2010 approximately 97% of eligible children were enrolled in Medicaid/CHIP and only 3.2% of the total children in DC were uninsured.
A third explanation could be the increase in the number of youth between the ages 18 and 21. Youth between 18 and 21 are eligible for Medicaid/CHIP if their family income is below 200% of FPL. From 2000 to 2011, while the child population decreased, the 18 to 21 population in DC increased by approximately 5,000 according to the American Community Survey (ACS). It is possible that a significant number of the increasing 18 to 21 population are enrolled in Medicaid/CHIP.
There are other possible factors behind the Medicaid/CHIP enrollment increase between 2000 and 2011. Can you think of other factors behind the increase in DC’s Medicaid/CHIP enrollment while child population and poverty have decreased? These data matter because Medicaid/CHIP is one of the most important programs for the health and well-being of DC’s children, as our 2011 policy snapshot on Medicaid/CHIP explains.
Do also give us your feedback on the 2014 Ward Snapshots, your analysis of the indicators and tell us how the snapshots are useful to you!