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You and your children may be eligible for low-cost or free health insurance! Programs exist in every state and the District of Columbia. For information about low-cost and free children's health coverage, visit For information on coverage for adults, read the Guides to Finding Health Insurance Coverage in Your State from Cover the Uninsured.

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Retention: The Scope of the Challenge

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Document Type Retaining Eligible Children and Families in SCHIP and Medicaid
Factors that affect Medicaid and SCHIP retention, ways to improve the renewal process and coalition strategies designed to increase and promote retention.
File size: 5.2MB

Updated: 6.1.06      Printable Printable version

Difficulty understanding the scope of the challenge:
While experts assert that retention in Medicaid and SCHIP is a "big problem" and that a significant number of eligible children lose coverage each year, it is difficult to grasp the extent of the challenge. Experts concur that it is nearly impossible to compare data and retention rates across states. They say that states calculate their rates differently, use different definitions of retention and case closure, and often have poor data systems that do not accurately track what happens to families. Therefore, it is difficult to understand how many eligible children lose coverage each year.

There are many reasons why retention matters:
Experts assert that when children lose Medicaid or SCHIP coverage, it is likely that many become uninsured. Being uninsured means less access to health services and providers, which research shows leads to poorer health outcomes for many children. There are also financial reasons for addressing the issue of retention. Some experts argue that continuous coverage through Medicaid or SCHIP saves money because people use fewer services over time. Others point to high administrative costs stemming from frequent enrollments and disenrollments as a result of churning – keeping families enrolled long term costs less.

For a full report on the scope of the challenge in Medicaid and SCHIP retention, download the Covering Kids & Families Communications Strategies for SCHIP and Medicaid Retention guide.

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