The state has earned a $21 million bonus from the federal government for enrolling more children in a public-private health insurance program and making it easier for them to stay in it.
North Carolina was one of 23 states sharing $296 million in bonuses awarded for cutting application paperwork and exceeding enrollment targets.
N.C. Health Choice, the state version of the national Children's Health Insurance Program, enrolls about 150,000 children, according to the state Department of Health and Human Services. That's up from about 134,000 in 2010.
The program offers free or reduced-price insurance to children whose parents cannot afford private insurance. It was approved in 1997 and was reauthorized in 2009.
When the federal law was reauthorized two years ago, it included incentives for states that adopted at least five of eight strategies for streamlining applications and increased enrollment above set targets.
"Access to health insurance is one of the keys to starting children on the path to a healthy life," said Marilyn Tavenner, acting administrator at the federal Centers for Medicare & Medicaid Services, during a conference call with reporters on Wednesday.
The federal government covers about 75 percent of North Carolina's costs. Some families pay part of the medical bills.
"Part of the reason for the bonus is that it helps defray the costs the state has already incurred by adding more kids to the program," Cindy Mann, a deputy administrator with the Centers for Medicare and Medicaid Service, said during the conference call.
North Carolina did not qualify for a bonus last year, but this year was credited with cutting down on paperwork applicants fill out, using electronic databases to verify family information, and keeping children enrolled for a year at time.
The state does not require in-person interviews, which federal officials said are difficult for working parents to schedule.
North Carolina, like most other states, does not consider a family's assets, other than income, when determining children's eligibility.
"We know the only way children can succeed in education is if they show up to school healthy and ready to learn," said Mark Johnson, a spokesman for Gov. Bev Perdue.
"The Governor has made expanding health care coverage for eligible children a high priority in her administration, and today's announcement shows that work has paid off."
Adam Searing, director of a health-care advocacy group, applauded the work the state did on Health Choice to get the extra money.
Making sure parents don't have to repeatedly file paperwork may seem like a small administrative change, but it can make a significant difference in how many children have health insurance, he said.
"They're making changes that make things more efficient and more effective, and that's resulted in more kids getting enrolled," said Searing, director of the N.C. Health Access Coalition.
North Carolina was one of seven states that earned a bonus for the first time.
