Search

As reauthorization of the State Children's Health Insurance Program (SCHIP) looms, we examine the program's first decade and identify changes needed so that SCHIP can better serve its target population. We conclude that by many objective standards, SCHIP has been a success, but the challenge will be to maintain and build upon that success. Critical issues include the level and structure of federal funding; the continued problem of uninsurance among low-income children; the lack of information on quality, access, and costs; and whether SCHIP can serve as the foundation for addressing broader health care needs among low-income families.

This paper examines the extent to which the State Children's Health Insurance Program (SCHIP) might be substituting for private health insurance coverage at the time of enrollment. Among children who were newly enrolled in SCHIP in 2002 in ten states, about 14 percent had private coverage that they could have retained as an alternative to SCHIP. Of this 14 percent, about half of parents reported that the private coverage was unaffordable compared with SCHIP. This suggests that relatively few SCHIP enrollees could have retained private coverage and that even fewer had parents who felt that the option was affordable.

This paper examines successes and shortcomings of the State Children's Health Insurance Program (SCHIP). SCHIP is a source of coverage for millions of children, improving their access to health care and sparking innovation in program design and improvements in Medicaid. However, SCHIP adds to the complexity of the insurance system and introduces new inequities in access to insurance; it is imperfectly targeting eligible children who are uninsured; and its financing is problematic because of the block-grant funding structure and use of SCHIP funds to cover adults. These issues need to be addressed during the SCHIP reauthorization process.

This paper examines how rates of uninsurance for low-income parents have been changing over time and the extent to which expanding coverage to parents through Medicaid and the State Children's Health Insurance Program (SCHIP) could help them. We find that uninsurance rates have been rising for low-income parents, especially those living in poverty, and that Medicaid and SCHIP could greatly reduce uninsurance among parents and would likely increase their access to care. Such expansions would still leave many noncitizen parents uninsured and would require reaching and enrolling families whose children have remained uninsured despite being eligible for public coverage.

Congressional attempts to curtail spending growth in Medicare home health may affect Medicaid, given the number of Medicare enrollees who qualify for Medicaid-covered home care services. This DataWatch examines interactions between the Medicare and Medicaid home care programs using state-level expenditure data for 1995 and through case studies in five states: Connecticut, Louisiana, Minnesota, New Mexico, and New York.