12-Month Continuous Eligibility

07 December 2015 Written by  

12-month Continuous Eligibility 
for Children on Medicaid

Continuous eligibility is a state option that allows children ages 0-18 to maintain Medicaid coverage for one full year, even if families experience a change in income or family status. By implementing continuous eligibility, Utah could ensure that for 365 days a year children get—and keep—health coverage.1
When children are enrolled in a program for 12 continuous months, they can receive appropriate preventive care. Families do not have to delay treatment for medical issues or emergencies that arise. Stable coverage enables providers to establish relationships with children to make sure their health and development is on track.2 
Without continuous eligibility, parents are penalized for trying to improve their family’s economic circumstances through temporary or seasonal work. In many cases, families must drop out of Medicaid after securing temporary or seasonal work. When the short-term job ends, they must re-enroll to receive benefits. This creates an unnecessary burden for families. 
ContinuousEligibilityChildrenwithDisruptedCoverageContinuous eligibility is already available to children enrolled in CHIP, but not to children enrolled in Medicaid. Continuous eligibility leads to significantly fewer disruptions in health insurance coverage for children enrolled in CHIP compared to children enrolled in Medicaid. By implementing continuous eligibility for the CHIP program, Utah stabilized access to healthcare for eligible children.Meanwhile, 18% of children in Medicaid continue to have disrupted access to healthcare.
1. Georgetown Center for Children and Families. (March 2009). Program Design Snapshot: 12 Month Continuous Eligibility. Available at http://ccf.georgetown.edu/wp-content/uploads/2012/03/CE-program-snapshot.pdf
2. Irvin, Carol, et al. Discontinuous coverage in Medicaid and the implications of 12-month continuous coverage for children. No. 3110. Mathematica Policy Research, 2001. Available at http://www.mathematica-mpr.com/~/media/publications/PDFs/discontinuous.pdf
Voices for Utah Children supports  12-month Continuous Eligibility  for Children on Medicaid.Twelve-month eligibility is a critical way to make sure that Utah children have health insurance the entire year.    All children should have access to healthcare without disruptions in coverage.


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12-month Continuous Eligibility for Children on Medicaid

For 30 years now, Voices for Utah Children has called on our state, federal and local leaders to put children’s needs first. But the work is not done. The children of 30 years ago now have children of their own. Too many of these children are growing up in poverty, without access to healthcare or quality educational opportunities.

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JessieJessie Mandle, Senior Health Policy Analyst, joined the organization in 2015. Prior to joining Voices for Utah Children, Jessie was a Senior Program Planner with the San Francisco Department of Children, Youth and Their Families, where she focused on nutrition and Out of School Time areas. Jessie also worked as a policy researcher in Johannesburg, South Africa and oversaw a CDC grant for Multnomah County Aging and Disability Services in Portland, Oregon. Most recently, she worked with the Utah Department of Health and the Utah Cancer Action Network. Jessie has a Master's degree in Public Heath from Portland State University and a B.A. in Government from Wesleyan University in Connecticut.