Georgia is one of 23 states that will receive a performance bonus for enrolling eligible children in government health insurance programs, but the amount is far less than last year’s award.
The Centers for Medicare & Medicaid Services said Wednesday that Georgia will receive a bonus of $1.9 million. The state’s bonus last year was almost $5 million.
2011 was the first year that Georgia got this performance bonus, funded under legislation that reauthorized the Children’s Health Insurance Program (CHIP).
A state qualifies for a federal bonus by implementing procedures to simplify enrollment and renewal to ensure that all eligible children have easier access to coverage under Medicaid and CHIP, which in Georgia is known as PeachCare.
To qualify, states must meet at least five of eight enrollment benchmarks set by the federal government. They also must exceed targets for enrolling the lowest-income children
The consumer advocacy group Voices for Georgia’s Children, which has closely tracked the enrollment process, said Wednesday that it’s pleased that the state has qualified for bonuses for two straight years.
But Dante McKay, a Voices official, said the group is disappointed that the state’s 2012 award is lower than for the previous year, and that among the 23 states getting an award this year, Georgia ranked 22nd in the size of the bonus it received.
“What this signals is that we could be doing more to enroll and retain eligible children in public health insurance options,” said McKay, associate policy director for child health at Voices for Georgia’s Children. “Further, I am disappointed that we are leaving money on the table. When I look at the total awards that our neighbor Alabama has received since the performance bonuses were established ($43 million), and compare to our awards ($6.8 million), I wonder what they are doing that we aren’t.”
Southeastern states receiving bonuses this year were Alabama, $15.6 million; North Carolina, $17.9 million; South Carolina, $2.4 million; and Virginia, $20 million. The total amount to be awarded exceeds $305 million this year.
“States are ensuring more children get the health care they need,” Acting CMS Administrator Marilyn Tavenner said. “We are proud to reward states that are reducing enrollment barriers and connecting kids to coverage.”
The state Department of Community Health said Georgia qualified for the bonus, in part, because of its elimination of in-person interview requirements and its use of the same application and renewal forms for Medicaid and PeachCare.
Another factor is “Express Lane Eligibility,” in which the state uses information that families already have submitted to the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) to help make an eligibility determination for Medicaid or PeachCare.
Georgia obtained a bonus because of its work to improve the enrollment process for PeachCare and Medicaid and make it less bureaucratic and more cost-effective, said Pam Keene, a spokeswoman for Community Health.
Medicaid, the health insurance program for the poor and disabled that’s jointly funded by the federal and state governments, covers more than 1 million Georgia children. PeachCare, the program for uninsured children of middle-income parents, covers about 210,000.
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