Performance Improvement 2001. Cost Implications of Providing 12 Months' Continuous Coverage for Children Under Public Health Insurance Mechanisms


The purpose of this study is to assess the effect of extending 12 months of continuous eligibility for Medicaid or CHIP on the administrative and service costs of caring for children. The Balanced Budget Act of 1997 authorized each State: 1) to provide twelve months of continuous Medicaid eligibility for children and 2) to increase the Medicaid match for continuous eligibility under CHIP. However, some States may consider this too expensive to implement versus a two to six-month Medicaid eligibility. Site visits will be made to four States and Medicaid administrative data will be analyzed. Monthly enrollment data and annual expenditure information from 1995 State Medicaid Research Files (SMRF) person summary files, supplemented with site visit information, will be used to estimate the costs of an additional month of coverage. Service cost estimates will be drawn from both fee-for-service and managed care sectors. Estimates of administrative savings will be based on interviews with State personnel and any reduction in the number of re-determinations of eligibility conducted by States (presumptive eligibility). Institutionalized children and children enrolled in the Supplemental Security Income program will not be included in the analysis.


AGENCY SPONSOR: Maternal and Child Health Bureau

FEDERAL CONTACT: Jacob Tenenbaum, 301-443-9011

PIC ID: 7236

PERFORMER: Mathematica Policy Research, Inc., Washington, DC