CHIP: Study Reveals Disparities Among States

      While the Children's Health Insurance Program is likely to increase the number of insured children and expand their access to physician services, a 10-state study published in this week's Journal of the American Medical Association found that CHIP's effectiveness varies significantly among states. "These are encouraging results," RAND economists Stephen Long and M. Susan Marquis said, adding, "They show the promise of CHIP to significantly increase insurance coverage of low-income children and to improve their access to physician services throughout the nation" (RAND release, 6/1). The study, which is among the first to analyze data by state, included more than 8,500 participants in Colorado, Florida, Minnesota, New Mexico, New York, North Dakota, Oklahoma, Oregon, Vermont and Washington. While "providing public coverage would increase annual physician visits from 2.3 to 4.6 (a 105% increase) ... the increase would range from 41% to 189% across states," researchers found. The estimated increases in utilization were lowest in Minnesota and New York and highest in New Mexico, Vermont and Oregon -- differences which reflect variances in income distribution, past differences in public and private insurance coverage and "the availability of safety net services to the uninsured." Those states with the highest safety net capacities were also the states with the highest access for the uninsured (Colorado, Minnesota and New York). The researchers recommended that once CHIP is fully implemented across the nation, retrospective evaluations be completed to determine effectiveness before and after CHIP implementation (Long/Marquis, JAMA, 6/2).