(Photo courtesy of Creative Commons).

The focus is on children younger than 19 years old from households with annual incomes up to $45,000 for a family of four. According to Bloomberg, some states have more generous criteria.

Maryland received the most in 2011 bonuses with $28.3 million. Virginia followed with $26.7 million, then Colorado with $26.1 million.

To win bonuses, states presumptively enrolled children who appeared to be eligible and used electronic databases rather than paperwork submissions from families to verify incomes, Bloomberg reported.

A study by the Georgetown University Health Policy Institute reported that the number of uninsured children decreased from 6.9 million in 2008 to 5.9 million in 2010.

The study showed that Massachusetts had the lowest rate of uninsured children and Nevada had the highest, Bloomberg reported. 

Tricia Brooks, a senior fellow at the Georgetown institute said that children drop off programs after their parents don't renew eligibility.

"Families may avoid routine preventive care with the hope they'll have more money next month or delay seeking care until they know they really have to bring the children in," Brooks told Bloomberg. "At that point, the emergency room is a likely choice."

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Reach executive producer Agnus Dei Farrant here.