Children's Health Insurance Program: An Evaluation (1997 - 2010)


Childrens Health Insurance Program: An Evaluation (1997 - 2010)

Interim Report to Congress

December 21, 2011

By: Sheila Hoag, Mary Harrington, Cara Orfield, Victoria Peebles, Kimberly Smith, Adam Swinburn, Matthew Hodges, Kenneth Finegold, ASPE, Sean Orzol, Wilma Robinson, ASPE

Submitted by: Mathematica Policy Research, Inc.

Project Director: Mary Harrington, MathematicaContract Number: HHSP23320095642WC/HHSP23337021TMathematica Reference Number: 06873.130

ASPE Project Officers: Wilma Robinson and Rose Chu

This report is availble on the Internet at:

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This interim report is the first of two reports to Congress that will be developed as a part of the CHIP 10-state evaluation.  It documents what is known about the CHIP program as of Federal fiscal year (FFY) 2010 and previews the issues to be examined in future evaluation activities and reported in a subsequent Report to Congress to be submitted in 2013.  The main data source for this report is the CHIP Annual Reporting Template System (CARTS), a comprehensive reporting system established by the Centers for Medicare and Medicaid Services (CMS) for States to report on their CHIP programs.  Data from the CHIP Statistical Enrollment Data System (SEDS) are also used for the analyses of enrollment in public coverage, and data from the Current Population Survey are used to document coverage trends from 1997 to 2010.  In addition, published and unpublished literature on CHIP is used to provide motivation and context for the findings.


Executive Summary


  1. Context for an Updated Federal Evaluation of CHIP
    1. Purpose of this Report
    2. History and Evolution of CHIP
    3. Overview of the Federal Evaluations of CHIP
    4. Data Sources for this Report
    5. Road Map for the Report
  2. Design Features of CHIP Programs
    1. Core Design Features
    2. Substitution of CHIP for Private Coverage (Crowd Out)
    3. Other Options in CHIP to Expand Coverage to Children
    4. Adult Coverage Options
    5. Discussion
  3. Outreach Strategies and Application Processes
    1. Background and Motivation
    2. CHIP Outreach Strategies
    3. CHIP Application Processes and Procedures
    4. Discussion
  4. Enrollment and Retention Policies and Practices
    1. Background and Motivation
    2. Enrollment in Public Coverage
    3. Retention of Eligible Children
    4. Discussion
  5. CHIP's Role in Coverage for Low-Income Children
    1. Coverage Trends During the CHIP Era: 1997 to 2010
    2. Discussion
  6. Assessing Child Health Quality Through Performance Measures
    1. Background and Motivation
    2. Methods Used to Report Child Health Quality Measures
    3. Measures Reported by States, FFY 2010
    4. Discussion
  7. Program Challenges and Accomplishments
    1. Political and Fiscal Environment, FFY 2010
    2. Greatest Challenge Reported by States, FFY 2010
    3. Accomplishments Reported by States, FFY 2010
    4. Implications of the Affordable Care Act for State CHIP Programs


Appendix A: Additional Tables


"index.pdf" (pdf, 2.69Mb)

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