View Research by Author - Allison Cook

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This paper provides national and state level estimates of Medicaid/CHIP participation rates and of the number of uninsured children who are eligible for the program based on 2008 data from the American Community Survey. The results point to a national Medicaid/CHIP participation rate of about 82 percent, with varying participation rates across states and amongst groups of children. As of 2008, an estimated 4.7 million uninsured children were eligible for Medicaid/CHIP but not enrolled, of whom about 60 percent were concentrated in 10 states.

The Massachusetts Health Insurance Survey (MHIS) collects information on health insurance coverage and access to and use of health care for the non-institutionalized population in Massachusetts. It is funded by the Massachusetts Division of Health Care Finance and Policy (DHCFP) and is conducted by the Urban Institute, along with its subcontractor, Social Science Research Solutions (SSRS). This report examines health care access and use in 2008 in Massachusetts.

For children currently enrolled in Medicaid and CHIP, the health reform bills in the House and Senate present both potential benefits and risks in terms of the type of coverage these children would have and their access to needed care. This brief estimates the number of children enrolled in Medicaid and CHIP who would have been affected if provisions in pending health reform bills were implemented in 2007. Potential tradeoffs associated with shifting children from CHIP into Medicaid or new exchange plans are discussed.

This brief examines the characteristics of the children who were eligible for Medicaid/CHIP in 2007. The results show that while participation rates were high in both Medicaid and CHIP, some 5 million remained uninsured despite being eligible for coverage. Participation rates, which were found to vary across areas, have likely increased given recent declines in the number of uninsured children. The brief also shows that while interest in public coverage is high among low-income parents, many do not know not know that their child is eligible for Medicaid/CHIP, do not know how to apply, and/or find the application process difficult.

In this analysis, a health reform scenario is modeled that would expand Medicaid to an estimated 17.0 million uninsured individuals with incomes up to 133 percent of the federal poverty level (FPL), would provide subsidies to 16.3 million uninsured individuals with incomes between 133 and 399 percent of the FPL, and would require an additional 4.3 million uninsured individuals to obtain coverage through an individual mandate, though they would not be eligible for Medicaid or subsidies. The first brief contains an overview of the entire nonelderly uninsured population, and the three remaining briefs address children, parents and childless adults, respectively.

Emotions are flaring as constituents speak their minds to members of Congress home for August recess. That's to be expected, since health care is both a personal and public issue, but let's not forget to debate the basics:

In this paper and brief, the authors discuss alternative ways that health reform could be financed. They analyze different options including several proposals for delivery system reforms and for reduction in Medicare and Medicaid payments. They estimate the cost savings that could occur due to the introduction of a public plan option. Finally, they explore a range of revenue options. The key message of the paper is that health reform can be paid for, but it is best to obtain funds from a large number of measures to spread the burden broadly.

Medicaid provides a strong platform on which reform efforts to expand health insurance coverage can be built as two-thirds of the nation’s uninsured are low-income. Medicaid coverage could be broadened to reach more of the low-income uninsured by eliminating categorical restrictions and establishing a national eligibility standard based on income. This paper analyzes several options for expanding Medicaid using various income eligibility thresholds for adults and children under both current and enhanced participation rates. The analysis shows coverage and cost implications of the options, as well as impacts by region and with payment rates adjusted to promote provider participation.

With the reauthorization of the State Children’s Health Insurance Program (SCHIP) under consideration in early 2009, an important question is the extent to which uninsured children could be covered under employer-sponsored insurance (ESI) through premium assistance programs. Only 440,000 uninsured children who are eligible for Medicaid or SCHIP have at least one parent with ESI coverage. Since many more uninsured children are eligible for public programs than have access to ESI through their parents, policies to increase enrollment and retention in Medicaid and SCHIP have much greater potential than premium assistance programs to close coverage gaps among children.

This comparative case study describes the organization, delivery, and content of care of three maternity care models serving low-income women at risk of poor birth outcomes in Wards 5, 6, and 7 in Washington D.C. The first model, a birth center, provides prenatal care, birth services, postpartum follow-up, and infant and child health care. The second is a safety net clinic, which provides a variety of primary health care services, as well as prenatal care services. A not-for-profit teaching and research hospital represents a third option in which prenatal and postnatal care is provided through an on-site obstetric clinic.

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