Performance Improvement 2008. State Child Health Insurance: How Successful?


This study summarized and analyzed evaluations of both State and external activities related to the State Children´s Health Insurance Program (SCHIP). Established in 1997, SCHIP provides medical coverage for children under age 19 who are not eligible for Medicaid and with family incomes below 200 percent of the Federal poverty level or 50 percentage points above the current State Medicaid limit. States are required to examine and track the impact of SCHIP in reducing the numbers of low-income uninsured children. The study analyzed the effect of SCHIP on enrollment expenditures, use of services in Medicaid and State health programs, stand-alone and Medicaid expansion programs, and effectiveness of outreach activities and quality of care.

States embraced the flexibility that SCHIP offered, and enrollment grew rapidly in the early years due to the state´s multifaceted and evolving outreach efforts. States outreach and enrollment initiatives had a "spillover effect" on traditional Medicaid enrollment (more individuals sought or were moved into traditional Medicaid), although the precise magnitude of the effect was unknown. In most states, over 75 percent of children enrolled in SCHIP remain so, similar to the experience in the individual market and traditional Medicaid.  SCHIP contributed to improvements in children´s health insurance coverage, including substantial reductions in both the number and rate of uninsured children. Access to care for children enrolled in SCHIP varied by state. Access to care improved for children enrolled in SCHIP, although some gaps remained. 

Report Title: "National Evaluation of the State Children´s Health Insurance Program: A Decade of Expanding Coverage and Improving Access." Sponsor: CMS-ORDI, Office of Research, Development, and Information
Federal Contact: Susan Radke, 410-786-4450
Performer: Mathematica Policy Research, Inc.

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