Continuous Medicaid eligibility from birth to six is proposed, priced by its added state share, and followed to whoever stops paying when coverage gaps close, in NU506 Unit 9. Searches like "nu 506 unit 9 assignment example", "nu506 unit 9 sample" and "nu506 unit 9 example" land here.
Covered From Birth to Kindergarten: A Policy Proposal for Continuous Medicaid Eligibility to Age Six, With Its Price and Where the Savings Land
[Student Name]
Purdue University Global
NU506: Health Policy, Ethical, and Legal Perspectives of the Health Care System
Unit 9 Assignment
[Instructor Name]
[Date]
The state, its enrollment data and its budget figures are composite and bracketed; the federal law and research cited are published. Federal approval policy is recorded as of the date of writing.
The Problem: Procedural Loss
Last year, [9,800] children under six in the composite state were disenrolled from Medicaid at annual renewal. Within six months, [61] percent of them were enrolled again, which means most were still eligible when they lost coverage. The state's own renewal data show that most of these disenrollments were procedural: a renewal form not returned, a notice sent to an old address, a document missing. Families moved, changed jobs or missed a letter, and a child who qualified the whole time went uninsured for weeks or months.
This pattern, leaving and returning within months, is often called churn. Federal analysis has documented that churn disrupts continuity of care and adds administrative cost for states and families alike (Sugar et al., 2021). For young children, the months without coverage fall during the period of the most frequent well-child visits and vaccinations.
The Federal Route
Federal law now requires states to provide twelve months of continuous eligibility to children under 19 in Medicaid and CHIP, a requirement added by the Consolidated Appropriations Act, 2023, that took effect in January 2024. A state that wants longer continuous eligibility must seek federal approval, usually through a Section 1115 demonstration. Federal policy expects such demonstrations not to raise federal spending above what it would otherwise have been over their term, and federal policy on approving multiyear continuous eligibility has shifted between administrations. This proposal records the approval status as of the date it was written and would be revised if federal policy changed before submission.
The Proposal
The state requests a Section 1115 demonstration to provide continuous Medicaid eligibility from birth until a child's sixth birthday for any child enrolled before that age, without annual renewal, ending only if the family moves out of state, requests disenrollment, or the child dies. Children who enroll at age five would receive coverage until age six or for twelve months, whichever is longer.
The Cost, First
The cost is the additional member-months of coverage for children who would otherwise have been disenrolled and stayed off, plus the months of coverage for those who would have returned.
Additional member-months: of the [9,800] children disenrolled each year, about [3,800] stay off for six months or longer. If all [9,800] instead remained enrolled, the added coverage would be about [58,000] member-months a year, allowing for the months children would have been covered anyway after re-enrolling.
Cost per member-month: about $[260] for children under six in the state's managed care program.
Total cost: [58,000] times $[260] equals about $[15.1] million a year in total spending. At the state's federal matching rate of [60] percent, the state share is about $[6.0] million a year.
Where the Displaced Costs Land Now
Coverage gaps are not free; their costs fall on someone else, and the proposal names each party.
The state agency itself: every procedural disenrollment followed by re-enrollment requires a new application, verification and processing. At about $[180] per re-enrollment and about [6,000] re-enrollments a year, that is about $[1.1] million the agency spends processing children who never stopped being eligible.
Hospitals and clinics: a child without coverage who needs care often arrives at an emergency department or receives care the provider cannot bill, adding to uncompensated care.
Families: bills during gaps, delayed prescriptions and missed well-child visits, and time spent reapplying.
Counties: some counties fund safety-net pediatric care for uninsured children.
Research on continuous eligibility supports the direction of these effects. In a national analysis of children, state continuous eligibility policies were associated with higher rates of insurance, fewer gaps in coverage, fewer gaps due to application problems and a lower probability of being in fair or poor health, although not with changes in overall health care use (Brantley & Ku, 2022). The proposal therefore does not claim to pay for itself; it claims to move a known cost from families, providers and the agency's own processing work onto the program that is meant to carry it.
Opposition
Three objections are expected. First, the proposal would cover some children whose family income rises above the limit during the six years. That is true, and it is the price of eliminating procedural loss; the proposal estimates the share is small at these ages and argues the administrative savings offset part of it. Second, budget neutrality to the federal government may be hard to demonstrate. The proposal would present savings from fewer re-enrollments and from reduced churn in the federal share, and would accept a shorter demonstration term if needed. Third, some legislators oppose any expansion of Medicaid spending. For them, the proposal's case is administrative: it removes repeated paperwork for children who are already eligible.
At the Pediatric Clinic
Under the current system, a nurse at a well-child visit sometimes finds that a four-year-old's coverage lapsed two months earlier because a renewal letter went to an old address. The four-year vaccines are due. The clinic must either give them under the state's vaccine program and absorb the visit cost, or ask the family to come back after reapplying, and some do not return. Under continuous eligibility, the nurse opens the chart, sees active coverage, gives the vaccines and schedules the next visit. The policy change would be invisible to the family, which is the point.
References
Brantley, E., & Ku, L. (2022). Continuous eligibility for Medicaid associated with improved child health outcomes. Medical Care Research and Review, 79(3), 404-413. https://doi.org/10.1177/10775587211021172
Consolidated Appropriations Act, 2023, Pub. L. No. 117-328, 136 Stat. 4459 (2022).
Sugar, S., Peters, C., De Lew, N., & Sommers, B. D. (2021). Medicaid churning and continuity of care: Evidence and policy considerations before and after the COVID-19 pandemic (Issue Brief No. HP-2021-10). Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health and Human Services.
How this NU506 Unit 9 example is structured
The proposal is organized so that its cost cannot be missed. Procedural loss frames the problem, which comes first: children still eligible who lost coverage anyway, because that is what continuous eligibility addresses and what a state agency can verify from its own data. Next, the federal route is explained plainly: statute sets the twelve-month floor, and anything longer requires federal approval. Cost follows immediately, before benefits, so the budget office meets the price ahead of any case for paying it. The displaced-cost section is the paper's core, naming each party that currently absorbs the cost of coverage gaps, families, hospitals and county agencies, and estimating the shift. Opposition comes next, including concern about covering children whose families' income rises. At the end, the change is shown at a well-child visit, where a nurse no longer finds a vaccine schedule broken by a lapse.
Get an NU506 Unit 9 example written to your instructions
Bring the change your NU506 Unit 9 proposal argues for, even as a rough idea, plus the state and the grading criteria. The free first proposal comes back within 24-48h with its cost estimated before its benefits, the displaced costs traced to the families, hospitals or agencies absorbing them now, and the federal or state route named. The paper above is an original model document written by our desk, not a submitted student paper and not an official Purdue University Global document.
NU506 Unit 9 questions, answered
How precise does the cost estimate need to be?
Rough but transparent. Show the formula, the inputs and where each came from, and label assumptions. An estimate within a reasonable range with visible reasoning earns more than a precise figure with no derivation. State Medicaid budget documents and federal matching rates are the usual starting points for enrollment and cost inputs.
What are displaced costs?
Costs a policy moves from one party to another rather than creating or eliminating. Covering more children shifts spending onto the state and federal budgets while reducing what families, hospitals and county offices currently bear for coverage gaps. A strong proposal identifies each party on both sides and estimates the direction and rough size of each shift.
Should the proposal address political feasibility?
Yes, briefly. Name the likely opposition, its argument and its influence, and explain how the proposal responds, whether through a phased start, a sunset clause or evaluation requirements. A proposal that ignores feasibility reads as academic; one that anticipates the budget committee's questions reads as something an agency could actually submit.