Citation URL: http://www.urban.org/JoshuaMcFeeters

Using state survey data, researchers examined Medicaid supplemental payments, including disproportionate share hospital and upper payment limit payments in 2005 and changes in these payments between 2001 and 2005. The researchers found that states increased their use of general funds in financing Medicaid DSH payments while expanding the size and scope of other supplemental payments considerably. Although the federal government has made some headway in reforming state Medicaid financing in recent years, the paper concludes that problems persist and more work remains.

This study examines the effects of new and higher premiums on SCHIP enrollment in Kansas, Kentucky, and New Hampshire—three states that implemented premium changes in 2003. We used state administrative enrollment records from 2001 to 2004–2005 to track changes in total caseloads, new enrollments, and disenrollment timing in premium-paying categories of SCHIP before and after the premium changes were implemented. Premium hikes were associated with lower caseloads in all three states and with earlier disenrollment in Kentucky and New Hampshire. Premium increases appeared to have greater disenrollment effects for lower-income children in New Hampshire and for nonwhite children in Kentucky.
Inquiry, Volume 43, Number 4 (Winter 2006/2007): 378-392

Six out of ten low-income, uninsured children in Los Angeles County had difficulty accessing needed medical care in 2002/2003. Based on the Los Angeles County Health Survey, it appears that L.A.’s Children’s Health Initiative has the potential to improve access to health care services for these children if they enroll in public health programs. This analysis suggests that children enrolled in the Healthy Kids program would have fewer unmet health and dental needs and would be more likely to receive well-child and regular care.

Since 2003, the Children's Health Initiative of Greater Los Angeles has sought to reduce uninsurance rates among children in Los Angeles County. Using the 2002/2003 Los Angeles County Health Survey to examine the variation in health care access and use among children with public coverage prior to the Initiative, it appears that certain subgroups are experiencing problems. The Children's Health Initiative of Greater Los Angeles will not have as great an impact on improving children's health unless these barriers are addressed.

One in every ten children in Los Angeles County lacked health insurance coverage in 2002/2003. This brief uses L.A. County Health Survey data to assess how these children could be reached. Findings suggest that the Healthy Kids Program and L.A.'s Children's Health Initiative have the potential to substantially reduce uninsurance rates for L.A.'s children without eroding private coverage. A renewed push to enroll more children in public health programs could also reduce the uninsurance rate variations — especially with respect to citizenship status.

We studied the effects of health insurance, health care needs, demographic and area characteristics on out-of-pocket health care spending for low and higher income insured populations using the 2002 National Survey of America's Families. Results show that families with non-group insurance have the highest odds of experiencing high out-of-pocket expenses and high financial burden regardless of income, and that public insurance appears to offer the best financial protection from high out-of-pocket expenses and financial burden for low-income families. For higher-income families, having family members in fair or poor health is a risk factor for high out-of-pocket expenses and financial burden. (Medical Care, 44(3), March 2006, pp: 200-209)

Using data drawn from the 2002 National Survey of America's Families, this study explores the ways in which levels of preventive dental care and unmet dental needs vary among subgroups of low-income children. More than half of low-income children without health insurance had no preventive dental care visits. Levels of unmet dental needs among low-income children who had private health insurance coverage but no dental benefits were similar to those among uninsured children. Children of parents whose mental health was rated as poor were twice as likely to have unmet dental needs as other children. (American Journal of Public Health, 95(8): 1360-1366)

After slow growth during much of the 1990's, Medicaid physician fees increased, on average, by 27.4 percent between 1998 and 2003. The greatest growth occurred for primary care fees. States with the lowest relative fees in 1998 increased their fees the most, but almost no states changed their position relative to other states or Medicare. Physicians in states with the lowest Medicaid fees were less willing to accept most or all new Medicaid patients in both 1998 and 2003. However, large fee increases were associated with an increased willingness of primary care physicians to accept new Medicaid patients (Health Affairs Web Exclusive, June 23, 2004.)

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