Preserving Progress
As the end of the COVID-19 Public Health Emergency (PHE) draws nearer, the situation with Virginia’s CHIP and Medicaid programs (FAMIS programs) can be characterized as a “Best of times, Worst of times” scenario. Virginia is making great progress addressing coverage disparities and inequities. The state recently expanded FAMIS/Medicaid (F/M) eligibility (coverage of undocumented pregnant people, extension of post-partum coverage from 60 days to 12 months, elimination of the 40 Quarter Rule) and added dental services for adults. Combined with Medicaid expansion, effective January 1, 2019, now is the best of times for the nearly 2 million Virginians who rely on this important coverage.
The end of the PHE threatens much of the enrollment progress achieved since 2019. Significant disenrollment, added to the large numbers of eligible children, parents and pregnant people not yet covered, would quickly become the worst of times for these families. The Virginia Health Care Foundation (VHCF) will use HEALTHY KIDS 2022 (HK) funds ($1,486,611 over 3 years) and its seasoned, productive Application Assisters (AAs) to prevent inappropriate coverage loss (particularly for African-American, Hispanic and other Virginians of color, likely to be disproportionately disenrolled), preserve the progress Virginia has made in the last 3 years, and enroll more of those eligible, but uncovered.
HK-funded AAs will work in 9 of the Virginia localities with the highest numbers of uninsured F/M-income-eligible children (Alexandria, Arlington, Fairfax, Henrico, Loudoun, Prince William, Norfolk, Richmond City, Virginia Beach). Together, they are home to 43% of the state’s F/M income-eligible, uninsured children (18,236) (US Census, Small Area Health Insurance Estimates, 2019) and thousands of income-eligible parents and pregnant people. AAs will provide 1:1 application assistance to enroll or renew F/M coverage for 5,832 Virginians during the 3-year CA period.
F/M outreach and enrollment (O&E) aligns perfectly with VHCF’s mission to increase access to primary health care for uninsured and medically-underserved Virginians. Maximizing the number enrolled in state-sponsored health insurance is a core goal in VHCF’s Strategic Plan. The Foundation has led Virginia’s private sector F/M O&E for 23 years, and has developed substantial O&E experience and a deep knowledge-base. VHCF has trained, supported and coached more than 200 AAs since 1999, who have enrolled/retained more than 128,500 Virginians (mostly children and pregnant people).
VHCF will maximize enrollment and retention of eligible children, parents and pregnant persons in F/M with a 2-generation approach, helping household members of all ages apply for or renew coverage. AAs will use both best practices and innovative strategies, engage in effective partnerships, and monitor results to achieve goals. Clear, consistent messaging throughout the year regarding F/M (value, eligibility criteria, benefits, application/renewal process, #Enroll365) and free, 1:1 application assistance, virtual and in-person, will be used.
Virginia has made exciting progress expanding eligibility and services in F/M since 2019, attracting more enrollees and playing an important role in bridging racial and demographic health coverage disparities. VHCF aims to maximize enrollment/renewals through 1:1 application assistance and ensuring local partners/stakeholders are prepared for the coming tsunami of renewals. HK funds will continue the work of experienced, valued and productive AAs in communities with high numbers of potentially-eligible children, parents and pregnant people; their focus will be on those with lower education levels, those who do not speak English well and/or are at disproportionate risk of being inappropriately disenrolled from F/M.