Children's eligibility and coverage: Recent trends and a look ahead

Health Affairs

Volumn 26, Issue 5, 2007, Pages

  Hudson, Julie L ^a   Selden, Thomas M ^a  

^a AGENCY FOR HEALTHCARE RESEARCH AND QUALITY   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ARTICLE; CHILD; CHILD HEALTH CARE; CLASSIFICATION; ECONOMICS; EPIDEMIOLOGY; ETHNIC GROUP; FORECASTING; HEALTH CARE COST; HEALTH SURVEY; HUMAN; INCOME; LEGAL ASPECT; MEDICAID; MIGRATION; ORGANIZATION AND MANAGEMENT; PATIENT; SOCIAL SECURITY; SOCIOECONOMICS; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

AID TO FAMILIES WITH DEPENDENT CHILDREN; CHILD; CHILD HEALTH SERVICES; ELIGIBILITY DETERMINATION; EMIGRATION AND IMMIGRATION; ETHNIC GROUPS; FORECASTING; HEALTH CARE SURVEYS; HEALTH EXPENDITURES; HEALTH SURVEYS; HUMANS; INCOME; MEDICAID; MEDICALLY UNINSURED; SOCIOECONOMIC FACTORS; UNITED STATES;

EID: 35048872261     PISSN: 02782715     EISSN: 02782715     Source Type: Journal    
DOI: 10.1377/hlthaff.26.5.w618     Document Type: Article

References (38)

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3. G. Kenney and J. Yee, "SCHIP at a Crossroads: Experiences to Date and Challenges Ahead," Health Affairs 26, no. 2 (2007): 356-369.
4. J.W. Cohen et al., "The Medical Expenditure Panel Survey: A National Health Information Resource," Inquiry 33, no. 4 (1996): 373-389;
5. and S.B. Cohen, Sample Design of the 1996 Medical Expenditure Panel Survey Household Component, MEPS Methodology Report no. 2, Pub. no. 97-0027 (Rockville, Md.: AHRQ, 1997).
6. T.M. Selden, J.L. Hudson, and J.S. Banthin, "Tracking Changes in Eligibility and Coverage among Children, 1996-2002," Health Affairs 23, no. 5 (2004): 39-50, and references therein.
7. Program rule sources include the Urban Institute's Welfare Rules Database, http://www.urban.org (accessed 1 November 2006);
8. National Governors Association, MCH Update 2005: State Coverage of Pregnant Women and Children (Washington: NGA, 2006)
9. and earlier years; sources listed in Selden et al., "Tracking Changes"; as well as information from state Web pages, the Centers for Medicare and Medicaid Services, and discussions with state programadministrators.
10. Following L.C. Dubay, J. Haley, and G.M. Kenney, Children's Eligibility for Medicaid and SCHIP: A View from 2000, Assessing the New Federalism Series B, no. B-41 (Washington: Urban Institute, 2002), our simulation used legal status probabilities by age, race/ethnicity, poverty, arrival date, and region that were generously provided by Randolph Capps, Jeffrey Passel, and Kenneth Sucher (all of the Urban Institute). Immigrant children who were eligible for separate state programs but ineligible for federally funded coverage were assigned to the Medicaid and SCHIP eligibility groups according to income.
11. Dubay et al., Children's Eligibility.
12. American Academy of Pediatrics, "Fact Sheet: Children's Health Insurance," 16 April 2007, http://www.aap.org/research/factsheet.pdf (accessed 24 July 2007).
13. J. Holahan, A. Cook, and L. Dubay, Characteristics of the Uninsured: Who Is Eligible for Public Coverage and Who Needs Help Affording Coverage?February 2007, Appendix Table A1, http://www.kff.org/uninsured/ upload/7613.pdf (accessed 15 May 2007).
14. G.M. Kenney and A. Cook, Coverage Patterns among SCHIP-Eligible Children and Their Parents, 9 February 2007, http://www.urban.org/ publications/311420.html (accessed 24 July 2007).
15. K. Finegold and L. Giannarelli, TRIM3 Simulations of Full-Year Uninsured Children and Their Eligibility for Medicaid and SCHIP, June 2007, http://aspe.hhs.gov/health/reports/07/trim-uninsured-simulation/index.htm (accessed 24 July 2007).
16. Ibid.
17. See also C.L. Peterson, "Description of the Varying Estimates of Uninsured Children Who Were Eligible for Public Coverage," Memorandum (Washington: Congressional Research Service, 21 June 2007).
18. C.L. Peterson and E.J. Herz, "Estimates of SCHIP Child Enrollees Up to 200 Percent of Poverty, Above 200 Percent of Poverty, and of SCHIP Adult Enrollees," Memorandum (Washington: CRS, 2006).
19. An expanded version of Exhibit 3 can be found online at http://content.healthaffairs.org/cgi/content/full/hlthaff.26.5.w618/DC2.
20. For a similar analysis in 1994-95, see A. Davidoff et al., "Medicaid-Eligible Children Who Don't Enroll: Health Status, Access to Care, and Implications for Medicaid Enrollment," Inquiry 37, no. 2 (2000): 203-218.
21. Selden et al., "Tracking Changes," 48.
22. For instance, D.C. Ross and L. Cox, Beneath the Surface: Barriers Threaten to Slow Progress on Expanding Health Coverage of Children and Families: A Fifty State Update on Eligibility, Enrollment, Renewal, and Cost-Sharing Practices in Medicaid and SCHIP (Washington: Kaiser Commission on Medicaid and the Uninsured, 2004).
23. Recent contributions include J.L. Hudson, T.M. Selden, and J.S. Banthin "The Impact of SCHIP on Insurance Coverage of Children," Inquiry 42, no. 3 (2005): 232-254;
24. and A. Sommers et al., "Substitution of SCHIP for Private Coverage: Results from a 2002 Evaluation in Ten States," Health Affairs 26, no. 2 (2007): 529-537.
25. See, for example, T.M. Selden and J.L. Hudson, "Access to Care and Utilization among Children: Estimating the Effects of Public and Private Coverage," Medical Care 44, no. 5 Supp. (2006): I-19-I-26;
26. L. Dafny and J. Gruber, "Public Insurance and Child Hospitalizations: Access and Efficiency Effects," Journal of Public Economics 89, no. 1 (2005): 109-129;
27. L. Dubay and G.M. Kenney, "Health Care Access and Use among Low-Income Children: Who Fares Best?" Health Affairs 20, no. 1 (2001): 112-121;
28. and J.S. Banthin and T.S. Selden, "The ABCs of Children's Health Care: How the Medicaid Expansions Affected Access, Burdens, and Coverage between 1987 and 1996," Medical Care 44, no. 2 (2003): 133-145.
29. Selden et al., "Tracking Changes"; M. Rosenbach et al., Implementation of the State Children's Health Insurance Program: Synthesis of State Evaluations (Baltimore: Centers for Medicare and Medicaid Services, 2003);
30. and G. Kenney and D.I. Chang, "The State Children's Health Insurance Program: Successes, Shortcomings, and Challenges," Health Affairs 23, no. 5 (2004): 51-62.
31. L. Dubay, J. Holahan, and A. Cook, "The Uninsured and the Affordability of Health Insurance Coverage," Health Affairs 26, no. 1 (2007): w22-w30 (published online 30 November 2006; 10.1377/hlthaff.26.1.w22).
32. T.M. Selden and B.M. Gray, "Tax Subsidies for Employment-Related Health Insurance: Estimates for 2006," Health Affairs 25, no. 6 (2006): 1568-1579.
33. T.M. Selden and J.L. Hudson, "How Much Can Really Be Saved by Rolling Back SCHIP? The Net Cost of Public Health Insurance for Children," Inquiry 42, no. 1 (2005): 16-28.
34. G. Kenney, J. Hadley, and F. Blavin, "Effects of Public Premiums on Children's Health Insurance Coverage: Evidence from 1999 to 2003," Inquiry 43, no. 4 (2006): 345-361.
35. See, for instance, G. Flores et al., "A Randomized, Controlled Trial of the Effectiveness of Community-Based Case Management in Insuring Uninsured Latino Children," Pediatrics 116, no. 6 (2005): 1433-1441.
36. G.M. Kenney, J.M. Haley, and F.C. Ullman, Most Uninsured Children Are in Families Served by Government Programs (Washington: Urban Institute, 2000);
37. S. Dorn and G.M. Kenney, Automatically Enrolling Eligible Children and Families into Medicaid and SCHIP: Opportunities, Obstacles, and Options for Federal Policymakers, 16 June 2006, http://www.cmwf.org/publications/ publications_show.htm?doc_id=376814 (accessed 24 July 2007);
38. and D. Horner, W. Lazarus, and B. Morrow, "Express Lane Eligibility," Future of Children 13, no. 1 (2003): 224-229.