Enroll children and adults 55–64

Year 1, Day 1 · UHA; employers; statesDiscuss this step

Every concrete action this step requires, who is responsible, and when it happens relative to enactment.

#	Action	Owner	When	Trade-off
2.2.1	Convert children in Medicaid and CHIP (about 37M) automatically.	UHA / states	Day 1	Automatic conversion of children ends churn but transfers kids from state programs states designed.
2.2.2	Enroll privately insured children and adults 55–64 from IRS and employer records. Employer plans may not cover them for UHP services after Day 1.	UHA / employers	Day 1	Moving 55–64-year-olds out of employer plans cuts employer costs but splits families between systems.
2.2.3	Employers re-price family coverage for workers who still have it: children are removed, and premiums drop accordingly.	Employers / insurers	Day 1	Removing children lowers family premiums but leaves employers re-pricing plans mid-transition.
2.2.4	Pediatric dental and vision: participating pediatric dentists are paid from Day 1.	UHA	Day 1	Paying pediatric dentists from Day 1 expands access but tests dental billing systems at scale immediately.
2.2.5	Newborns: enrolled at birth from the hospital's birth record; no application.	UHA / hospitals	Day 1	Birth-record enrollment guarantees newborn coverage but depends on hospital data quality.