State Children's Health Insurance Program

This report synthesizes findings from case studies conducted in 2001 and 2002 in ten states selected for the Congressionally Mandated Evaluation of SCHIP: California, Colorado, Florida, Illinois, Louisiana, Missouri, New Jersey, New York, North Carolina, and Texas (Hill et al. 2002). Discussion addresses such issues as program design, outreach and enrollment strategies, benefits, service delivery systems, cost sharing, crowd out prevention, parental coverage, financing, and coordination of SCHIP and Medicaid. Overarching conclusions identify lessons learned from effective implementation.

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.

This report summarizes the roundtable "Infants and Toddlers in State and Federal Budgets: Yesterday's Choices, Today's Decisions, Tomorrow's Options" conducted by the Urban Institute, with support from the A.L. Mailman Family Foundation, on March 30, 2009. The roundtable's focus grew out of the widely perceived mismatch between sharply limited public investments on infants and toddlers and an accumulated body of research demonstrating the significance of the earliest years of life. We describe the group's diverse perspectives and wide-ranging discussion of strategies to address this mismatch.

For the Robert Wood Johnson Foundation's Covering Kids and Families evaluation (CKF), researchers conducted focus groups to explore parents' experiences accessing health care for their children, and to assess whether these experiences affected decisions to enroll their children in Medicaid or the State Children's Health Insurance Program (SCHIP). In each community, groups were conducted with parents of children insured by Medicaid or SCHIP and parents of uninsured children. Researchers concluded that even when parents encountered problems accessing care, very few indicated that this discouraged them from enrolling their children into Medicaid or SCHIP, or from renewing their children's public coverage.

Findings from interviews with low-income parents, part of the Robert Wood Johnson Foundation's Covering Kids & Families Evaluation, indicate that parental concerns about access to and quality of care under Medicaid/SCHIP do not reduce enrollment of eligible children in these programs. The positive feedback on the programs from parents of enrolled children—and the strong desire of almost all parents of uninsured children to enroll their children—attest to the success that states have had in publicizing their public health insurance programs and addressing concerns associated with them. However, administrative barriers often serve as a deterrent to enrollment and renewal.