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Secrets to Success: An Analysis of Four States at the Forefront of the Nation’s Gains in Children’s Health Coverage

This analysis, based on site visits and interviews with key stakeholders, examines the experiences of Alabama, Iowa, Massachusetts and Oregon in significantly improving health coverage of children in recent years through Medicaid and the Children’s Health Insurance Program.

Several common themes underlie these states’ successful efforts: At least one state political leader made coverage of children a top priority. All four states have expanded eligibility for children to 300 percent of poverty and have streamlined and simplified enrollment and renewal processes for families. Medicaid and CHIP agencies in each state have strong relationships with providers and community organizations to broaden outreach and enrollment efforts. And each state has promoted close alignment between Medicaid and CHIP, with Massachusetts and Oregon fully unifying the two programs.

Policy Brief (.pdf)