March 18, 2025 • 19 mins
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Health Affairs' Senior Deputy Editor Rob Lott interviews Erica Eliason of Rutgers University on her recent paper that explores how continuous eligibility policies and the Children's Health Insurance Program (CHIP) structure affected children's coverage loss during Medicaid unwinding.
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Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Rob Lott (00:31):
Hello, and welcome to A Health Odyssey. I'm your host,
Rob Lott. When it comes toprograms like Medicaid and CHIP,
the Children's Health InsuranceProgram, one of the thorniest
challenges is churn. That is thetemporary loss of coverage in
(00:53):
which enrollees disenroll andthen reenroll within a short
period of time, often due to anindividual's changing status and
eligibility, as well aspotential administrative
hurdles, like paperwork andfiling requirements. Some
studies have shown churn ratesas high as ten percent for
children on Medicaid and CHIP inrecent years.
(01:16):
Of course, this problem is notimpossible. One of the most
effective policy interventionsaimed at reducing coverage loss
is known as continuous coverageor continuous eligibility. This
is where essentially, once thechild is enrolled, they're good
to go for a full twelve months.They're not going to be kicked
(01:36):
off. They're not going to havetheir eligibility reassessed or
redetermined.
States have had the option ofoffering continuous eligibility
as far back as 1997, but onlysome have chosen to do so. That
changed with some pandemic erapolicy shifts, then changed
(01:56):
again after the pandemic, andthen changed once more in 2024.
What can we learn from all ofthese policy shifts about the
best ways to maintain children'scoverage and, ultimately, to
ensure those kids can get thecare and stability they need to
grow and thrive. That's thesubject of today's health
(02:18):
policy. I'm here with doctorErica Eliasson, assistant
professor in the department ofurban global public health at
Rutgers School of Public Health,together with her coauthors,
Daniel Nelson and Aditi Vasan.
Doctor Eliasson has afascinating new article in the
March issue of Health Affairsexamining the effect of
(02:42):
continuous eligibility policiesand chip structure on children's
coverage loss during the socalled Medicaid unwinding. There
is so much to learn from theirfindings, so let's just get into
it. Doctor Erica Eliasson,welcome to Health Odyssey.
Erica Eliason (03:00):
Thank you for having me.
Rob Lott (03:01):
Let's maybe, take a step back, start with some some
context from from pre pandemic.What was the status of
continuous eligibilityprovisions across the states
before COVID, and then how didthe sort of COVID era
flexibility change things?
Erica Eliason (03:19):
As you mentioned briefly, even before the the
pandemic policy changes, stateshad the option to offer twelve
months of continuous Medicaideligibility, for children, which
allowed them to keep thatcoverage for a year even if
there were changes in theireligibility during that time. So
(03:41):
before the pandemic about halfof states had this policy option
in place for children at the 12level but then in response to
the public health emergencythere was the Families First
Coronavirus Response Act whichoffered states enhanced federal
(04:02):
funds in exchange for thecontinuous enrollment of
Medicaid beneficiaries. So thatpolicy was in place starting
March 2020 until 2023, April '20'20 '3 which is when states
could start rolling back thatpolicy. So from, that twenty
(04:22):
twenty to '20 '20 '3 period, allMedicaid enrollees had
continuous Medicaid coverage.
Rob Lott (04:29):
What do we know about the effect of continuous
eligibility on people's healthand well-being?
Erica Eliason (04:35):
Research from the twelve month continuous
eligibility policies forchildren prior to the pandemic
policies, found that continuouseligibility increases coverage
stability, decreases unmethealth care needs and improves
health outcomes. Then some workhas found that this has even
(04:59):
greater improvements for somechildren like children with
special health care needs whohave more ongoing demands for
medical care so they mightparticularly benefit from having
that continuous enrollment.
Rob Lott (05:15):
Gotcha. Now, there's another element here that, your
paper delves into, which is thatdifferent states structure their
CHIP programs in different ways.Can you say a little more about
those differences and, how thatcomes into play here?
Erica Eliason (05:31):
So there are about, I guess, three structures
that states tend to use fortheir CHIP programs. So the
first one is building off of theMedicaid program that they have.
And that's referred to as aMedicaid expansion chip so those
children get all the samebenefits that they would in
(05:52):
Medicaid. But if states take adifferent approach where they
offer it as a totally separatetype of insurance which is
called separate CHIP then stateshave more flexibility in the
design of their CHIP insurance.And then the third option is a
(06:12):
combination approach referred toas combination CHIP where they
have some elements of, theMedicaid expansion CHIP and then
some, separate CHIP as well.
Rob Lott (06:22):
Gotcha. Okay. And do you have a sense of, how that
breaks down from state to state?What's sort of the most common
structure?
Erica Eliason (06:30):
Oh, yes. A combination chip is the most
common. And then at the time ofthe unwinding, there are only
two states that had just aseparate chip. The continuous
coverage policy that was inplace during the pandemic did
not apply to separate chip.
Rob Lott (06:44):
Gotcha. Okay. Alright. So alright. Now, tell us a
little bit about the unwinding.
When did that take place, andwhat did it mean for continuous
eligibility?
Erica Eliason (07:00):
Yeah. So, the unwinding process, means that
states were able to start theirMedicaid disenrollment
procedures again. So, stateswere able to do this starting in
April of twenty twenty three butthey didn't all start in April
2023. There was a bit of astaggered rollout and the
(07:25):
unwinding, the reinitiating ofdisenrollment was generally over
around twelve months, butthere's some state variation in
that as well.
Rob Lott (07:34):
Okay. So, your paper looked at this sort of this
critical moment. The unwindingbegins. Presumably, there's
gonna be some coverage loss, asa result of the that process.
And am I correct?
Your paper basically looked athow much loss there was and how
(07:56):
it varied according to whichpolicies were in place before
the pandemic as well as whichCHIP structure was in place. Is
that a fair description?
Erica Eliason (08:05):
Yes. I looked at how, children's Medicaid and
CHIP enrollment changed, as aresult of the unwinding and then
across states that had twelvemonth continuous eligibility or
not for children in place priorto the pandemic and then CHIP
structure.
Rob Lott (08:23):
So what approach did you use to ask those questions?
Erica Eliason (08:27):
Yes. Okay. So we used monthly Medicaid and CHIP
enrollment data for children forstates that they report to CMS
and, is publicly available onthe CMS website. And we use the
period of January 2021, whilethe policy, the pandemic policy
(08:47):
was in effect, through December2023. So the unwinding period
for that time was April 2023 toDecember 2023 but we took into
account the different initiationstart dates that states had and
we used data for all statesexcept for Arizona because
(09:07):
Arizona did not reportchildren's enrollment separately
from adults enrollment.
So we did an interactive timeseries model so we were able to
look at how enrollment changedin the first month of the
unwinding for the state and thenin the subsequent period,
through December of twentytwenty three.
Rob Lott (09:28):
And then give us some of the top line findings. What
did you learn from that process?
Erica Eliason (09:31):
The top line finding is that the unwinding
was associated with declines inthe proportion of children who
were enrolled in Medicaid orCHIP. As we expected, there was
coverage loss, from theunwinding and then there were
differences significantdifferences by CHIP structure as
well as significant differencesby whether or not a state had a
(09:56):
twelve month continuouseligibility policy. So by CHIP
structure we found largerdeclines among states with
combination CHIP compared toMedicaid expansion CHIP and then
by continuous eligibility policywe found larger declines in
(10:18):
states that did not have twelvemonth continuous eligibility for
children compared to states thatdid have a twelve month
continuous eligibility policies.
Rob Lott (10:28):
Alright. That seems pretty clear. Next up, I'm
hoping we can talk a little bitabout the mechanisms behind
these changes. But first, let'stake a quick break. And we're
(10:55):
back.
I'm here with RutgersUniversity's doctor Erica
Eliason, and we're talking aboutthe impact of changes in
continuous eligibility policiespost pandemic. So, doctor
Eliason, you found differencesin the coverage losses by state.
I'm wondering if you can say alittle bit about in your at
(11:17):
least theoretically, whatexplains those differences.
Erica Eliason (11:21):
During the, pandemic policy, states that did
not have twelve month continuouseligibility already for children
saw, more increased coveragethan states that had twelve
month continuous eligibilitybecause those states were newly
implementing continuouseligibility they saw greater
(11:43):
benefits than states thatalready had twelve month
continuous eligibility. Althoughof course the continuous
eligibility during the pandemicwas over a longer period of time
so states that had twelve monthcontinuous eligibility did
benefit just past the point thatthe states that were newly
(12:05):
implementing continuouseligibility altogether. So the
larger gains in the states thatwere newly implementing
continuous eligibility indicatethat those children were more
influenced by the pandemicpolicy so as a result when the
pandemic policy was rolled backwe did find that children there
(12:27):
were at more risk of losing thiscoverage that had been gained.
Rob Lott (12:32):
Got it. So, essentially, states where there
was more room to gain also,perhaps had a greater risk of
loss on the other side of thepandemic.
Erica Eliason (12:43):
Exactly.
Rob Lott (12:44):
Okay. So after all of this, congress passed national
mandatory twelve monthcontinuous eligibility for
children in Medicaid and CHIPunder the, Consolidated
Appropriations Act of 2023, andthat took effect in January
2024. So after the unwinding,after your period of analysis.
(13:04):
And so I guess this raises thequestion, does this basically
render your research a sort ofartifact of history? I I don't
wanna call it obsolete, but,what is the, sort of, the
relevance of that period towhere we are today?
What are the lessons from theunwinding that can still be
(13:25):
applied in this new era underthis new requirement?
Erica Eliason (13:29):
Yeah. So I wouldn't say it's obsolete. So
one thing to note is, as ofJanuary 2024 all states had to
adopt twelve month continuouseligibility for children, but
the unwinding was stillhappening in some states during
that time. So what we wouldexpect from that is that that
(13:50):
new twelve month continuouseligibility period will dampen
children's coverage loss inthose states that are
reimplementing continuouseligibility. We won't really
expect effects in the statesthat already have the twelve
month continuous eligibility,but, we do expect that the
(14:10):
states that are reimplementingcontinuous eligibility will see
less coverage loss for children,as they reimplement the policy.
Rob Lott (14:18):
Gotcha. Okay. So let's say you get a call from a state
Medicaid director, thisafternoon, and they're doing
some strategic planning for thenext few years, all the
uncertainty of the currentpolicy universe aside, and
they've read your paper. Itseems pretty important to their
(14:39):
work, but they're sort of havingsome trouble factoring it into
their plans for 2026 and beyond.What would you recommend?
How would you say they shouldread your paper? Through what
lens would you recommend theyview your article?
Erica Eliason (14:56):
So overall, what we found was, you know,
unsurprising that the unwindingled to lower Medicaid and CHIP
enrollment among children. But,I do think the fact that twelve
month continuous eligibilitypolicies were protective against
some coverage loss for childrenis still important since the
(15:16):
implementation of thosepolicies, nationally under the
CAA, occurred while states werestill completing their
unwinding. So, we would expect aflattening out of coverage loss
in those states. And I expectthat children in states newly
implementing those twelve monthcontinuous eligibility policies
will see benefits from thispolicy even though there was the
(15:40):
previous pandemic era policies.The other takeaway that is still
relevant moving forward is aboutthe CHIP structure piece.
So some states in preparation ofthe unwinding had actually
transitioned to Medicaidexpansion CHIP to try to reduce
enrollment barriers and ourstudy finds that this may have
(16:03):
been protective against coverageloss for children so this
approach was successful becauseMedicaid expansion chip is the
one that built off Medicaidprograms so there's more,
Medicaid chip integration there.I do think an overall takeaway
from all this is that thecontinuous enrollment periods
work to improve, children'sMedicaid and chip coverage.
Rob Lott (16:25):
Your paper alludes to multiyear continuous eligibility
as a potential policy option inthe future. What can you tell us
about that? How likely is thatto take effect in some of these
states?
Erica Eliason (16:38):
The most recent report I had seen was that 13
states are implementing orpursuing multi year continuous
eligibility, which is primarilyfor young children, in most
states age zero to five. And sobecause the pandemic policy was
in place 2020 to 2023, the multiyear continuous eligibility in
(17:00):
those 13 states would moreclosely follow the the coverage
patterns that children hadduring the pandemic, as opposed
to just the twelve monthcontinuous eligibility, which is
just for, one year. So Iactually think that there's a
lot that we can learn from thepandemic continuous eligibility
to inform multi year continuouseligibility including how that
(17:24):
affected children's health careaccess, things like unmet health
care needs, health care use, andthings like administrative
burden. And I I do have somework underway looking at, the
implications of the pandemicpolicy, for some of those
outcomes. Other work I think,will be interesting moving
(17:45):
forward is looking in thosestates that are implementing
multi year continuouseligibility compared to the
states that just keep the twelvemonth continuous eligibility.
So you know how does that affectchildren's coverage for long
periods, health health careoutcomes, and for which
children, you know, going backto research that found that
(18:08):
children with special healthcare needs may benefit more from
continuous eligibility policies.So, how children with special
health care needs in thosestates, how their health care
changes, or other children whoare more likely to experience
coverage loss prior to all ofthis, like Hispanic children,
(18:29):
they could potentially see,larger gains, than other groups.
And then, very, very long term,I think it will be interesting,
to look at any long term healtheffects, later in life, that
could last into adulthood.
Rob Lott (18:45):
Okay. I wanna say thank you, doctor Eliasson for
taking the time to, to be hereand, share your findings with
us.
Erica Eliason (18:54):
Yeah. Thanks so much.
Rob Lott (18:56):
To our listeners, thanks so much for tuning in. If
you enjoyed it, please recommendit to a friend. Smash that
subscribe button and tune innext week. Thank you. Thanks for
listening.
If you enjoyed today's episode,I hope you'll tell a friend
about a healthy policy.
Hello, and welcome to A Health Odyssey. I'm your host,
Rob Lott. When it comes toprograms like Medicaid and CHIP,
the Children's Health InsuranceProgram, one of the thorniest
challenges is churn. That is thetemporary loss of coverage in
(00:53):
which enrollees disenroll andthen reenroll within a short
period of time, often due to anindividual's changing status and
eligibility, as well aspotential administrative
hurdles, like paperwork andfiling requirements. Some
studies have shown churn ratesas high as ten percent for
children on Medicaid and CHIP inrecent years.
(01:16):
Of course, this problem is notimpossible. One of the most
effective policy interventionsaimed at reducing coverage loss
is known as continuous coverageor continuous eligibility. This
is where essentially, once thechild is enrolled, they're good
to go for a full twelve months.They're not going to be kicked
(01:36):
off. They're not going to havetheir eligibility reassessed or
redetermined.
States have had the option ofoffering continuous eligibility
as far back as 1997, but onlysome have chosen to do so. That
changed with some pandemic erapolicy shifts, then changed
(01:56):
again after the pandemic, andthen changed once more in 2024.
What can we learn from all ofthese policy shifts about the
best ways to maintain children'scoverage and, ultimately, to
ensure those kids can get thecare and stability they need to
grow and thrive. That's thesubject of today's health
(02:18):
policy. I'm here with doctorErica Eliasson, assistant
professor in the department ofurban global public health at
Rutgers School of Public Health,together with her coauthors,
Daniel Nelson and Aditi Vasan.
Doctor Eliasson has afascinating new article in the
March issue of Health Affairsexamining the effect of
(02:42):
continuous eligibility policiesand chip structure on children's
coverage loss during the socalled Medicaid unwinding. There
is so much to learn from theirfindings, so let's just get into
it. Doctor Erica Eliasson,welcome to Health Odyssey.
Erica Eliason (03:00):
Thank you for having me.
Rob Lott (03:01):
Let's maybe, take a step back, start with some some
context from from pre pandemic.What was the status of
continuous eligibilityprovisions across the states
before COVID, and then how didthe sort of COVID era
flexibility change things?
Erica Eliason (03:19):
As you mentioned briefly, even before the the
pandemic policy changes, stateshad the option to offer twelve
months of continuous Medicaideligibility, for children, which
allowed them to keep thatcoverage for a year even if
there were changes in theireligibility during that time. So
(03:41):
before the pandemic about halfof states had this policy option
in place for children at the 12level but then in response to
the public health emergencythere was the Families First
Coronavirus Response Act whichoffered states enhanced federal
(04:02):
funds in exchange for thecontinuous enrollment of
Medicaid beneficiaries. So thatpolicy was in place starting
March 2020 until 2023, April '20'20 '3 which is when states
could start rolling back thatpolicy. So from, that twenty
(04:22):
twenty to '20 '20 '3 period, allMedicaid enrollees had
continuous Medicaid coverage.
Rob Lott (04:29):
What do we know about the effect of continuous
eligibility on people's healthand well-being?
Erica Eliason (04:35):
Research from the twelve month continuous
eligibility policies forchildren prior to the pandemic
policies, found that continuouseligibility increases coverage
stability, decreases unmethealth care needs and improves
health outcomes. Then some workhas found that this has even
(04:59):
greater improvements for somechildren like children with
special health care needs whohave more ongoing demands for
medical care so they mightparticularly benefit from having
that continuous enrollment.
Rob Lott (05:15):
Gotcha. Now, there's another element here that, your
paper delves into, which is thatdifferent states structure their
CHIP programs in different ways.Can you say a little more about
those differences and, how thatcomes into play here?
Erica Eliason (05:31):
So there are about, I guess, three structures
that states tend to use fortheir CHIP programs. So the
first one is building off of theMedicaid program that they have.
And that's referred to as aMedicaid expansion chip so those
children get all the samebenefits that they would in
(05:52):
Medicaid. But if states take adifferent approach where they
offer it as a totally separatetype of insurance which is
called separate CHIP then stateshave more flexibility in the
design of their CHIP insurance.And then the third option is a
(06:12):
combination approach referred toas combination CHIP where they
have some elements of, theMedicaid expansion CHIP and then
some, separate CHIP as well.
Rob Lott (06:22):
Gotcha. Okay. And do you have a sense of, how that
breaks down from state to state?What's sort of the most common
structure?
Erica Eliason (06:30):
Oh, yes. A combination chip is the most
common. And then at the time ofthe unwinding, there are only
two states that had just aseparate chip. The continuous
coverage policy that was inplace during the pandemic did
not apply to separate chip.
Rob Lott (06:44):
Gotcha. Okay. Alright. So alright. Now, tell us a
little bit about the unwinding.
When did that take place, andwhat did it mean for continuous
eligibility?
Erica Eliason (07:00):
Yeah. So, the unwinding process, means that
states were able to start theirMedicaid disenrollment
procedures again. So, stateswere able to do this starting in
April of twenty twenty three butthey didn't all start in April
2023. There was a bit of astaggered rollout and the
(07:25):
unwinding, the reinitiating ofdisenrollment was generally over
around twelve months, butthere's some state variation in
that as well.
Rob Lott (07:34):
Okay. So, your paper looked at this sort of this
critical moment. The unwindingbegins. Presumably, there's
gonna be some coverage loss, asa result of the that process.
And am I correct?
Your paper basically looked athow much loss there was and how
(07:56):
it varied according to whichpolicies were in place before
the pandemic as well as whichCHIP structure was in place. Is
that a fair description?
Erica Eliason (08:05):
Yes. I looked at how, children's Medicaid and
CHIP enrollment changed, as aresult of the unwinding and then
across states that had twelvemonth continuous eligibility or
not for children in place priorto the pandemic and then CHIP
structure.
Rob Lott (08:23):
So what approach did you use to ask those questions?
Erica Eliason (08:27):
Yes. Okay. So we used monthly Medicaid and CHIP
enrollment data for children forstates that they report to CMS
and, is publicly available onthe CMS website. And we use the
period of January 2021, whilethe policy, the pandemic policy
(08:47):
was in effect, through December2023. So the unwinding period
for that time was April 2023 toDecember 2023 but we took into
account the different initiationstart dates that states had and
we used data for all statesexcept for Arizona because
(09:07):
Arizona did not reportchildren's enrollment separately
from adults enrollment.
So we did an interactive timeseries model so we were able to
look at how enrollment changedin the first month of the
unwinding for the state and thenin the subsequent period,
through December of twentytwenty three.
Rob Lott (09:28):
And then give us some of the top line findings. What
did you learn from that process?
Erica Eliason (09:31):
The top line finding is that the unwinding
was associated with declines inthe proportion of children who
were enrolled in Medicaid orCHIP. As we expected, there was
coverage loss, from theunwinding and then there were
differences significantdifferences by CHIP structure as
well as significant differencesby whether or not a state had a
(09:56):
twelve month continuouseligibility policy. So by CHIP
structure we found largerdeclines among states with
combination CHIP compared toMedicaid expansion CHIP and then
by continuous eligibility policywe found larger declines in
(10:18):
states that did not have twelvemonth continuous eligibility for
children compared to states thatdid have a twelve month
continuous eligibility policies.
Rob Lott (10:28):
Alright. That seems pretty clear. Next up, I'm
hoping we can talk a little bitabout the mechanisms behind
these changes. But first, let'stake a quick break. And we're
(10:55):
back.
I'm here with RutgersUniversity's doctor Erica
Eliason, and we're talking aboutthe impact of changes in
continuous eligibility policiespost pandemic. So, doctor
Eliason, you found differencesin the coverage losses by state.
I'm wondering if you can say alittle bit about in your at
(11:17):
least theoretically, whatexplains those differences.
Erica Eliason (11:21):
During the, pandemic policy, states that did
not have twelve month continuouseligibility already for children
saw, more increased coveragethan states that had twelve
month continuous eligibilitybecause those states were newly
implementing continuouseligibility they saw greater
(11:43):
benefits than states thatalready had twelve month
continuous eligibility. Althoughof course the continuous
eligibility during the pandemicwas over a longer period of time
so states that had twelve monthcontinuous eligibility did
benefit just past the point thatthe states that were newly
(12:05):
implementing continuouseligibility altogether. So the
larger gains in the states thatwere newly implementing
continuous eligibility indicatethat those children were more
influenced by the pandemicpolicy so as a result when the
pandemic policy was rolled backwe did find that children there
(12:27):
were at more risk of losing thiscoverage that had been gained.
Rob Lott (12:32):
Got it. So, essentially, states where there
was more room to gain also,perhaps had a greater risk of
loss on the other side of thepandemic.
Erica Eliason (12:43):
Exactly.
Rob Lott (12:44):
Okay. So after all of this, congress passed national
mandatory twelve monthcontinuous eligibility for
children in Medicaid and CHIPunder the, Consolidated
Appropriations Act of 2023, andthat took effect in January
2024. So after the unwinding,after your period of analysis.
(13:04):
And so I guess this raises thequestion, does this basically
render your research a sort ofartifact of history? I I don't
wanna call it obsolete, but,what is the, sort of, the
relevance of that period towhere we are today?
What are the lessons from theunwinding that can still be
(13:25):
applied in this new era underthis new requirement?
Erica Eliason (13:29):
Yeah. So I wouldn't say it's obsolete. So
one thing to note is, as ofJanuary 2024 all states had to
adopt twelve month continuouseligibility for children, but
the unwinding was stillhappening in some states during
that time. So what we wouldexpect from that is that that
(13:50):
new twelve month continuouseligibility period will dampen
children's coverage loss inthose states that are
reimplementing continuouseligibility. We won't really
expect effects in the statesthat already have the twelve
month continuous eligibility,but, we do expect that the
(14:10):
states that are reimplementingcontinuous eligibility will see
less coverage loss for children,as they reimplement the policy.
Rob Lott (14:18):
Gotcha. Okay. So let's say you get a call from a state
Medicaid director, thisafternoon, and they're doing
some strategic planning for thenext few years, all the
uncertainty of the currentpolicy universe aside, and
they've read your paper. Itseems pretty important to their
(14:39):
work, but they're sort of havingsome trouble factoring it into
their plans for 2026 and beyond.What would you recommend?
How would you say they shouldread your paper? Through what
lens would you recommend theyview your article?
Erica Eliason (14:56):
So overall, what we found was, you know,
unsurprising that the unwindingled to lower Medicaid and CHIP
enrollment among children. But,I do think the fact that twelve
month continuous eligibilitypolicies were protective against
some coverage loss for childrenis still important since the
(15:16):
implementation of thosepolicies, nationally under the
CAA, occurred while states werestill completing their
unwinding. So, we would expect aflattening out of coverage loss
in those states. And I expectthat children in states newly
implementing those twelve monthcontinuous eligibility policies
will see benefits from thispolicy even though there was the
(15:40):
previous pandemic era policies.The other takeaway that is still
relevant moving forward is aboutthe CHIP structure piece.
So some states in preparation ofthe unwinding had actually
transitioned to Medicaidexpansion CHIP to try to reduce
enrollment barriers and ourstudy finds that this may have
(16:03):
been protective against coverageloss for children so this
approach was successful becauseMedicaid expansion chip is the
one that built off Medicaidprograms so there's more,
Medicaid chip integration there.I do think an overall takeaway
from all this is that thecontinuous enrollment periods
work to improve, children'sMedicaid and chip coverage.
Rob Lott (16:25):
Your paper alludes to multiyear continuous eligibility
as a potential policy option inthe future. What can you tell us
about that? How likely is thatto take effect in some of these
states?
Erica Eliason (16:38):
The most recent report I had seen was that 13
states are implementing orpursuing multi year continuous
eligibility, which is primarilyfor young children, in most
states age zero to five. And sobecause the pandemic policy was
in place 2020 to 2023, the multiyear continuous eligibility in
(17:00):
those 13 states would moreclosely follow the the coverage
patterns that children hadduring the pandemic, as opposed
to just the twelve monthcontinuous eligibility, which is
just for, one year. So Iactually think that there's a
lot that we can learn from thepandemic continuous eligibility
to inform multi year continuouseligibility including how that
(17:24):
affected children's health careaccess, things like unmet health
care needs, health care use, andthings like administrative
burden. And I I do have somework underway looking at, the
implications of the pandemicpolicy, for some of those
outcomes. Other work I think,will be interesting moving
(17:45):
forward is looking in thosestates that are implementing
multi year continuouseligibility compared to the
states that just keep the twelvemonth continuous eligibility.
So you know how does that affectchildren's coverage for long
periods, health health careoutcomes, and for which
children, you know, going backto research that found that
(18:08):
children with special healthcare needs may benefit more from
continuous eligibility policies.So, how children with special
health care needs in thosestates, how their health care
changes, or other children whoare more likely to experience
coverage loss prior to all ofthis, like Hispanic children,
(18:29):
they could potentially see,larger gains, than other groups.
And then, very, very long term,I think it will be interesting,
to look at any long term healtheffects, later in life, that
could last into adulthood.
Rob Lott (18:45):
Okay. I wanna say thank you, doctor Eliasson for
taking the time to, to be hereand, share your findings with
us.
Erica Eliason (18:54):
Yeah. Thanks so much.
Rob Lott (18:56):
To our listeners, thanks so much for tuning in. If
you enjoyed it, please recommendit to a friend. Smash that
subscribe button and tune innext week. Thank you. Thanks for
listening.
If you enjoyed today's episode,I hope you'll tell a friend
about a healthy policy.
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