What Prevents State Covering Kids & Families’ Grantees from Achieving the Program’s Goals? A Synthesis of Findings on Barriers, 2003–2006

The Covering Kids & Families (CKF) initiative was designed to help overcome barriers that made it difficult for children and adults to enroll, and stay enrolled, in Medicaid and SCHIP programs. This report examines the types of barriers CKF grantees encountered when trying to achieve these goals. Most CKF grantees named environmental barriers—for example, limited state funding, policy changes, difficult processes, political climate, or government bureaucracy—as the greatest hurdles they faced. Other barriers included program-related problems, such as paperwork or staffing, and operational barriers, such as dealing with coalitions, geographic problems, or language barriers. Most grantees reported that these barriers affected enrollment and retention efforts, but more than half found ways to work through them. CKF coalitions helped grantees work through barriers in many instances.