Publications by Heidi Kapustka for Health Policy Center

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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.

SCHIP Administrators and other officials in 13 states reported very few cutbacks in eligibility or benefits in fiscal year 2002 despite state budget deficits surpassing $36 billion. Only New Jersey restricted eligibility -- to parents, not children. None of the states cut its benefit package. Many states did reduce their outreach efforts reflecting the perception that people knew about the program. Reasons SCHIP was not cut back include: it addresses a vital need and works well; it is not an entitlement; its relatively small size (compared to Medicaid), its high federal matching rate, and its political popularity. SCHIP could fall under the budget ax in 2003 given continued enrollment growth, deepening state budget deficits, and an uncertain future for federal funding.

The five-year-old State Children's Health Insurance Program (SCHIP), which currently benefits 3.8 million low-income children, faces its first real fiscal challenge as states contend with deficits surpassing $36 billion in fiscal 2002. What are the prospects for retrenchment of this joint federal-state endeavor? To answer that question, Urban Institute health policy researchers interviewed SCHIP administrators and other officials in 13 states during the summer of 2002. The study, part of the Urban Institute's multiyear SCHIP evaluation being conducted by its Assessing the New Federalism (ANF) project, looked at how SCHIP is faring in Alabama, California, Colorado, Florida, Massachusetts, Michigan, Minnesota, Mississippi, New Jersey, New York, Texas, Washington, and Wisconsin.

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