Children's public health insurance program improves health care outcomes for low-income children

In 1999, the Agency for Healthcare Research and Quality (AHRQ), The David and Lucile Packard Foundation, and the Health Resources and Services Administration (HRSA) formed a unique public/private partnership to create the Child Health Insurance Research Initiative (CHIRI™). CHIRI™ was an effort to supply policymakers with information to help them improve access to, and quality of, health care for low-income children. CHIRI™ funded nine studies of public child health insurance programs and health care delivery systems.

This Issue Brief highlights some of the CHIRI™ findings on the State Children’s Health Insurance Program (SCHIP), a Federal-State program implemented in 1997 and reauthorized in 2009 as the Children’s Health Insurance Program (CHIP). CHIP provides insurance coverage to low-income children whose families earn too much to qualify for Medicaid but lack private insurance. While the CHIRI™ research primarily was conducted from 1999 to 2003, the findings remain instructive for policymakers and others interested in improving children’s insurance coverage. Highlights include:

•Most SCHIP enrollees lived in families with a full-time worker and incomes equal to or below 150 percent of the Federal Poverty Level (FPL).
•Minority children and children with special health care needs (CSHCN) made up a significant proportion of SCHIP enrollees.
•SCHIP improved health care access and quality for low-income children generally; these gains were by and large shared by minority children and CSHCN.
•The design of coverage in States with separately administered SCHIP programs limited certain services for CSHCN.
•SCHIP retention was increased by a simplified renewal process that automatically reenrolled children in SCHIP unless their families submitted reenrollment forms indicating a change affecting their eligibility.
•More than three-quarters of SCHIP enrollees retained public insurance coverage more than a year after enrollment. However, others became uninsured and few obtained private insurance coverage.
•More than 70 percent of children enrolled in Oregon’s premium assistance program lacked access to an employer-sponsored plan and thus purchased their coverage in the individual market.

Read the full brief here:
http://www.ahrq.gov/chiri/chiribrf10/chiribrf10.pdf