Discontinuity of coverage for Medicaid and S-CHIP children at a transitional birthday.

Abstract:

RESEARCH OBJECTIVE:To investigate disenrollment from public insurance at the 6-year transitional birthday when eligibility for many children moves from Medicaid to State Children's Health Insurance Program (S-CHIP). DATA SOURCES:Data from Georgia's S-CHIP (PeachCare) and Medicaid programs from 2000 to 2002. STUDY DESIGN:The likelihood of dropping public coverage after the reference birthday is modeled for children turning age 6 compared with a control cohort of children turning age 9 controlling for demographic and geographic differences between enrollees. PRINCIPAL FINDINGS:Over 17 percent of 6-year-olds versus only 7 percent of the control cohort dropped coverage. After controlling for other factors (e.g., race/ethnicity, prior enrollment, and geographic region) having lower historical expenditures is predictive of dropping coverage among all children, although the unadjusted effect is stronger among children enrolled in PeachCare before their sixth birthday. Only 1 percent of Medicaid children who remained covered transitioned to PeachCare. CONCLUSIONS:Turnover at transitional birthdays identifies a common pathway for children into the ranks of the uninsured. Facilitating continuous enrollment would retain in the programs children with lower than average expenditures. This may be one of the more cost effective ways of reducing the number of uninsured children in Georgia.

journal_name

Health Serv Res

journal_title

Health services research

authors

Ketsche P,Adams EK,Snyder A,Zhou M,Minyard K,Kellenberg R

doi

10.1111/j.1475-6773.2007.00795.x

subject

Has Abstract

pub_date

2007-12-01 00:00:00

pages

2410-23

issue

6 Pt 2

eissn

0017-9124

issn

1475-6773

pii

HESR795

journal_volume

42

pub_type

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