View Research by Author - Genevieve M. Kenney

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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.

This report uses the 2005 Kaiser Low-Income Coverage and Access Survey to examine low-income parents' perceptions of access and quality of care for the uninsured. The findings indicate that most low-income parents perceive that the uninsured do not have access to affordable medical and dental care and that the quality of care they receive is lower than for the insured. Low-income parents also have generally positive perceptions of Medicaid, indicating that efforts to increase eligibility and enrollment in Medicaid such as those included in current health care reform proposals would reduce uninsurance among this population.

New data on health insurance coverage from the American Community Survey show extensive variation in rates of private and public coverage and uninsurance across congressional districts in the United States. Rates of private coverage are lowest in districts that have higher poverty rates which tend to be concentrated in the South and West and uninsurance remains most serious in districts with low rates of private coverage. This analysis identifies the districts in which residents would have the most to gain from health reforms that are designed to increase health insurance coverage toward a higher and more uniform national standard.

This brief examines the potential effects of health care reform on the more than 25 million children who currently have coverage under Medicaid or the Children's Health Insurance Program (CHIP). Increased parental coverage will help these children since many have uninsured parents with unmet health needs. However, proposals to move these children into a new health insurance exchange could make them worse off through the potential loss of benefits and legal protections and possible exposure to higher cost-sharing; alternatively, if reimbursement rates are higher in the exchange than paid under Medicaid and CHIP, children's access to providers could improve.

This paper examines work-limiting disability using the 1996 and 2001 panels of the Survey of Income and Program Participation. Nearly 10 percent of employed parents developed or had a recurring disability over the course of the panel. For about a quarter of this group, earnings dropped by more than 25 percent of family income, with other income sources offsetting only a small fraction of lost earnings. In addition, workers who hold health insurance policies through their employer were less likely to reduce hours worked or leave their job following disability onset, effects consistent with job lock.

This commentary outlines the policy issues surrounding reauthorization of SCHIP, including funding, eligibility, quality and access to care, and enrollment and retention, and discusses why the program was not reauthorized in 2007. It also addresses the impact of SCHIP on children and pediatricians and the future prospects for the program.

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.

As the reauthorization of the State Children's Health Insurance Program (SCHIP) and broader health care reform efforts are considered, important policy questions include where eligibility thresholds should be set for public coverage and how much latitude states should have in setting their thresholds. This analysis shows that employer-sponsored insurance premiums are less affordable for families at 300 percent of the FPL now than they were for families at 200 percent of the FPL in 1996, particularly in areas with a high cost of living and suggests the need to adjust eligibility thresholds for growth in health care costs.

State buy-in programs are designed to address coverage shortfalls among moderate- and higher-income children whose families are not eligible for Medicaid or SCHIP but who cannot afford, or do not have access to, private coverage. These programs allow families to buy their children into a comprehensive public insurance plan with low out-of-pocket cost sharing at an unsubsidized premium. As more states aim to achieve universal coverage for children, buy-in programs may be one component they consider in their plans to reach that goal. This brief explores some issues for states to consider before implementing a buy-in program.

This brief is the latest in a series using data from the 2005 Kaiser Low-Income Coverage and Access Survey to examine health coverage, access, and financial burdens associated with health care for young adults ages 19 to 29 in low-income families. The findings demonstrate that many low-income uninsured young adults experience problems gaining access to needed health care, with adverse consequences for both their health and financial well-being.

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