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On February 4, 2009, President Obama signed the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). This legislation marked a new era in children's coverage by providing states with significant new funding, new programmatic options, and a range of new incentives for covering children through Medicaid and the Children's Health Insurance Program (CHIP). One of the clear goals of the legislation is to support states in developing efficient and effective strategies to identify, enroll, and retain health coverage for uninsured children who are eligible for Medicaid or CHIP but are not enrolled. CHIPRA also provided flexibility to states to expand health care coverage to children who need it, and tasked the Secretary of Health and Human Services (HHS) with developing standards by which states can measure the quality of the care that children are receiving.

U.S. Census Bureau data show that, in 2008, the uninsured rate among children was at the lowest level since 1987, yet 7.3 million children did not have health insurance coverage that year. Many more children suffer gaps in coverage throughout the year. Most of these uninsured children are eligible for Medicaid and CHIP but are not enrolled. Although a great deal of progress has been made in recent years, administrative barriers can still make it difficult for families to enroll their children in health coverage programs and to keep their children covered for as long as they are eligible. In addition, many families either do not know about Medicaid or CHIP or mistakenly believe that their children are not eligible. Surveys show families are eager to sign their children up once they learn that they may be eligible, and families that are losing jobs and experiencing financial stress during the economic downturn describe CHIP and Medicaid as an essential financial support mechanism. Stable funding along with effective outreach, enrollment, and retention measures are critical to making further progress in ensuring that children across the nation have health coverage.

Beginning in 2009, CMS has worked closely with states, other federal departments, and a broad array of private and public leaders and organizations interested in children's coverage, to implement CHIPRA. These efforts are focused on promoting CHIPRA's goals by continuing down the successful paths that have already been forged as well as identifying new and innovative approaches to making the promise of health coverage a reality for all children. 

For more information and guidance regarding CHIPRA:

CHIPRA: Children Come First

Some of the features in CHIPRA that will help states and communities boost participation
rates among eligible children include: