Interim Evaluation Report: Congressionally Mandated Evaluation of the State Children’s Health Insurance Program. B. Selecting States and Gaining Their Cooperation

02/26/2003

Ten states were selected for this study in accordance with the legislative requirements. These ten states capture: (1) a high proportion of low-income uninsured children in the United States; (2) wide geographic (including urban/rural) representation, and (3) diverse approaches to program design. The selection process began with a list of 25 states, prepared by ASPE based on a wide array of factors, including the size of the SCHIP and Medicaid populations, the number of low-income uninsured children, representation of important subpopulations, program design features, maturity of program, and state data capability. 8 In addition, priority was given to selecting states from among the nine states included in the focus group study that was also a part of ASPE's evaluation. Based on a nonprobability, replicable protocol, ten states were selected: California, Colorado, Florida, Illinois, Louisiana, Missouri, New Jersey, New York, North Carolina, and Texas. 9 These ten states fulfill the legislatively specified selection criteria:

  • They include more than half (56 percent) of the target population of uninsured children with family income under 200 percent of the federal poverty level.
  • They include approximately 1.3 million of the children who were enrolled in SCHIP during at least part of the second quarter of federal fiscal year 2000, or about 53 percent of such children nationwide (Rosenbach et al. 2001).
  • All four Census regions are represented. Four of the ten states are in the South, and there are two states each in the other three regions (Northeast, Midwest, and West).
  • They include two states whose SCHIP programs are an expansion of their Medicaid programs, six states whose SCHIP programs are separate programs only, and two states with combination programs.

To capture additional diversity, other program design features were monitored and taken into consideration:

  • Income eligibility thresholds: Three of the ten selected states have an income threshold of 250 percent or more of the federal poverty level.
  • Medicaid waivers: Four of the states, including one of the two with a Medicaid expansion-only program, had approved or pending Medicaid Section 1115 demonstrations.

Finally, six of the ten states were among those included in the focus group study: California, Colorado, Florida, Missouri, New York, and Texas.

The states were keenly interested in the study. When approached about participating, all states agreed to cooperate with the evaluation contractor to provide access to state staff and to provide program enrollment data needed for the study, and all signed memoranda of understanding to do so. By the end of 2001, most of the states had supplied both test data and the enrollment data required for drawing the first sample wave of the survey of SCHIP enrollees and disenrollees. The two states selected for a survey of Medicaid enrollees and disenrollees--California and North Carolina--had by March 2002 signed memoranda of understanding to provide the necessary Medicaid enrollment data.10


8. The 25 states from which the 10 were chosen were: Alabama, Arizona, California, Colorado, Florida, Georgia, Illinois, Indiana, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Missouri, New Jersey, New York, North Carolina, Ohio, Oregon, Pennsylvania, South Carolina, Texas, Utah, and Virginia.

9. The statistical information used for state selection (and reported here) was the most recent available at the time of selection in early 2001. Note that Arizona was originally selected; but, because it was unable to participate, Colorado was selected as its replacement.

10. The states are being paid to provide the data for the evaluation. Therefore, the contractor has entered into subcontracts with each state or its contractor to supply the data.

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