North Carolina was recently awarded $21,135,087 to ensure that more children have health coverage. The performance bonus payment is funded under the Children’s Health Insurance Program Reauthorization Act, one of the first pieces of legislation signed into law by President Obama in 2009.

To qualify for these bonus payments, states must surpass a specified Medicaid enrollment target. They also must adopt procedures that improve access to Medicaid and the Children’s Health Insurance Program (CHIP), making it easier for eligible children to enroll and retain coverage. North Carolina is one of 23 states to share in over $296 million in Federal performance bonuses this year.

The bonuses come one week after new data from the Centers for Disease Control and Prevention show that the number of children with insurance increased by 1.2 million since the CHIP reauthorization in 2009. An HHS issue brief notes that this increase has been entirely due to greater enrollment in public programs such as Medicaid and CHIP.

“More of North Carolina’s children now have the advantages health coverage provides,” said Health and Human Services Secretary Kathleen Sebelius. “And North Carolina parents now have the security of knowing their children can get the health care they need without worrying that an illness could leave them with a lifetime of medical bills.”

North Carolina is receiving a performance bonus for the first time. The state has made several program improvements to streamline the children’s health coverage enrollment process. For example, the same forms are used to apply for Medicaid or CHIP (Health Choice for Children) and applicants are not required to appear for a face-to-face interview, which can be especially difficult for working parents.

In addition, North Carolina guarantees eligible children enrollment for a full year, ensuring that they get continuous coverage and that needed care is not disrupted. North Carolina also uses existing electronic databases to verify family information, reducing the need for families to submit paperwork when it is time to renew their children’s health coverage. This makes it easier for eligible children to keep their coverage for as long as they qualify.

Performance bonuses help offset the costs states incur when they enroll lower-income children in Medicaid. The bonuses also give states the incentive to streamline their enrollment and renewal procedures, ensuring long-term improvements in their children’s health insurance programs.

“Despite serious fiscal challenges, today’s awards show that children’s health remains a top priority for states,” said Cindy Mann, Deputy Administrator of the Centers for Medicare and Medicaid Services. “Not only have more states qualified for performance bonuses than in the past, but many have continued to improve the efficiency of their programs.”

The 23 states eligible for performance bonuses include Alabama, Alaska, Colorado, Connecticut, Georgia, Idaho, Illinois, Iowa, Kansas, Louisiana, Maryland, Michigan, Montana, New Jersey, New Mexico, North Carolina, North Dakota, Ohio, Oregon, South Carolina, Virginia, Washington, and Wisconsin.