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June 22, 2016

Let’s Put Out the ‘Welcome Mat’ So More Virginia Kids Get Health Insurance

More than 20,000 kids in Virginia may lack health insurance because lawmakers have refused to close the health care coverage gap for their parents. That’s because allowing more low-income adults to get health insurance also helps connect more low-income children with the coverage they’re already eligible for.

It’s called the “Welcome Mat” effect. As parents become eligible and enroll in their new coverage, they often learn that their children are also eligible for coverage through Medicaid or the Children’s Health Insurance Program (CHIP) and enroll them as well.

The Welcome Mat effect has huge potential benefits because “The majority – 62.1 percent – of uninsured children in 2014 were eligible for Medicaid or CHIP but not enrolled,” according to a recent Urban Institute report on children’s coverage. In Virginia, there are 107,000 uninsured children, according to a Kids Count report released yesterday, and 29 percent of the people potentially eligible for coverage if Virginia closed the gap are parents with dependent children residing in their home.

The Welcome Mat effect is on full display in Urban’s analysis, which shows that the gains in children’s coverage from 2013 to 2014 were substantially larger in states that expanded coverage for adults. Specifically, states that widened eligibility for adults saw a 67 percent larger increase in children’s participation than the states that have refused to cover more adults, like Virginia.

In fact, Virginia may have slipped backwards: the data indicate Virginia’s Medicaid/CHIP participation rate may have actually declined slightly from 2013 to 2014. The flagging participation means Virginia is now second lowest only to Indiana among states east of the Mississippi. And the decline contributed to a 15 percent increase in the share of Medicaid/CHIP eligible children without insurance.

These disappointing statistics are a step in the wrong direction.

Had Virginia’s children enjoyed the average Welcome Mat effect, Virginia’s Medicaid/CHIP participation rate would have been 92.1 percent rather than the 88.3 percent reported by Urban. That means 20,200 more Virginia children could have been covered by Medicaid/CHIP had state lawmakers closed the coverage gap, according to TCI analysis. To put it another way, nearly 1 in 5 Virginia children who are uninsured could have gotten coverage.   


We all want Virginia’s children and adults to be healthy. Sadly we have yet to move forward with one of the best ways to help them.

Health Care

Massey Whorley

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