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Objectives: To analyze relationships between Medicaid automatic enrollment for child Supplemental Security Income (SSI) recipients and health insurance coverage during transitions. Data Sources and Study Setting: Medical Expenditure Panel Study, 2000-2020 and National Survey for Children with Special Health Care Needs, 2001-2010. Study Design: Leveraging variation in SSI-Medicaid automatic enrollment status across regions and over time, we estimate a regression model to quantify associations between automatic enrollment and insurance coverage. We validate our findings in the NS-CSHCN. Data Collection: Our sample includes children receiving SSI for a disability. We also analyze a subsample of children newly enrolled in SSI. Principal Findings: Automatic enrollment is associated with a statistically significant increase in insurance coverage. Expanding automatic enrollment to all states is associated with increases in Medicaid enrollment of 3% (CI 0.9%-6.7%) among all SSI children and 7% (CI 1.1%-13.9%) among children newly enrolled in SSI. We find similar decreases in uninsurance. Analysis in the NS-CSHCN replicates these findings. Conclusions: Medicaid automatic enrollment policies are associated with increased insurance coverage for SSI children, particularly those transitioning into the program. Medicaid policy defaults could play an important role in reducing administrative burdens to improve children's coverage and access to care. KEYWORDS automatic enrollment, children with special health care needs, disabled persons, insurance coverage, Medicaid, Supplemental Security Income What is known on this topic * Gaps in insurance have significant consequences for children's health, particularly for children of color and children with complex health needs. * Automatic enrollment and express-lane eligibility policies increase Medicaid coverage in the general population of children. * During the 2000s, Medicaid automatic enrollment for children on Supplemental Security Income (SSI) led to declines in the uninsured rate and declines in caregiver burden for their families. What this study adds * The uninsured rate is higher (average 5.6%) among children transitioning into SSI than in the general child population (average 4%) * SSI-Medicaid automatic enrollment continues to have a strong relationship with insurance coverage for children on SSI in the post-ACA era * Expanding SSI-Medicaid automatic enrollment nationwide would be associated with a 3-7% increase in Medicaid enrollment (means 82-86%) among all SSI children and new child SSI enrollees, 1 | INTRODUCTION Medicaid provides critical health benefits to low-income and disadvantaged children, yet administrative burden prevents many eligible children from accessing needed care. (1,2) Defined as the learning, compliance, [...]

Objective: To estimate the effects of prenatal public health insurance targeting noncitizens on the health of U.S.-born children of noncitizen mothers beyond birth outcomes. Data Sources and Study Setting: This paper uses the restricted version of the 1998-2014 National Health Interview Survey with state-level geographic identifiers. Study Design: The empirical strategy compares outcomes in states that adopted the Children's Health Insurance Plan (CHIP) Unborn Child Option with states that never adopted or adopted it at different times, controlling for differences in the pretreatment period. I use a flexible event-study analysis to quantify the effects of the Unborn Child Option on noncitizen women's health insurance coverage, health care utilization, and their children's health. Data Collection/Extraction Methods: All data are derived from pre-existing sources. Principal Findings: The study finds that the impact of the Unborn Child Option is a 4.7%-point increase in public health insurance coverage (p < 0.01) and 0.48 more doctor's office visits (p < 0.1) annually among noncitizens of childbearing ages. Subsequently, the reform leads to a 7%-point rise in the rate of parents reporting their 4-6-year-old children are in 'excellent' or 'very good' health (p < 0.01). While no improvements are evident at birth and at younger ages, observed health improvements begin to appear by preschool age. Conclusions: The study contributes to the literature by providing evidence that certain benefits of in-utero public health insurance targeting noncitizens may appear several years after birth, specifically around preschool age. KEYWORDS access/demand/utilization of services, child and adolescent health, health economics, health policy/politics/law/regulation, maternal and perinatal care and outcomes What is known on this topic * Prior studies on the Children's Health Insurance Plan (CHIP) Unborn Child Option (UCO), a prenatal public health insurance option for noncitizens, find moderate increases in prenatal care utilization but no improvement in birth outcomes. * Literature on the impact of prenatal public health insurance eligibility has focused on US citizens. * Recent studies have shown significant effects of prenatal public health insurance eligibility on health and economic achievement in adulthood, but have not investigate intermediate outcomes in childhood. What this study adds * This study focuses on the UCO's impact beyond the neonatal period. * The findings show that observed health improvements begin to appear by preschool age, while no improvements are evident at birth and at younger ages. * This research demonstrates the impact of in-utero public health insurance eligibility for non-citizens on their US-born children's health, which has been understudied., 1 | INTRODUCTION Previous literature has shown that the prenatal environment is critical to the subsequent health trajectory experienced throughout life. (1-4) In an effort to improve the prenatal environment, [...]

Byline: Kelley M. Butler I'd be lying if I didn't say I'm glad that this month's cover feature and Health Care section highlight reporting on how employers can craft effective [...]