Two Recent Studies Assess States’ CHIP Programs
The following briefly describes the findings from two recent studies on states' CHIP programs:
- In states that do not require periodic re-enrollment verification, a "significantly lower" percentage of children lose their CHIP coverage than in states that do have such policies, according to a study by the Agency for Healthcare Research and Quality. Researchers examined re-enrollment policies in Kansas, New York and Oregon, which require parents to inform state officials periodically about their children's eligibility statuses, and Florida, which only requires parents to inform the state if their children's eligibility status changes. Only a "handful" of states nationwide have such "passive re-enrollment" policies. The study found that Florida's passive re-enrollment policy contributed to a lower disenrollment rate than the three other states, which have more stringent re-enrollment requirements. Five percent of Florida CHIP beneficiaries lost coverage during re-enrollment processes, compared with 33% to 50% of beneficiaries in Kansas, Oregon and New York. About 25% of children in Kansas, New York and Oregon who lost CHIP coverage at time of re-enrollment regained coverage within two months, the study found. Study leader Andrew Dick of the University of Rochester's School of Medicine and Dentistry said, "The rapid return of these children indicates that administrative issues such as active re-enrollment and other requirements may be the reason for their disenrollment, while others may have obtained health care coverage from other sources." The study appears in the June 2002 issue of Health Care Financing Review (AHRQ release, 6/17).
- As part of its Assessing the New Federalism project, the Urban Institute has released a report describing the efforts of Minnesota, New Jersey, Rhode Island and Wisconsin to expand CHIP coverage to include parents of enrolled children. Those states already had covered parents through Medicaid or other state-only funded programs, but obtained section 1115 Medicaid demonstration waivers in 2001 that allowed them to use CHIP program funds to insure parents. Researchers found that Minnesota's, Rhode Island's and Wisconsin's rates of uninsurance among parents with annual incomes less than 200% of the federal poverty level are lower than the national rate, 34.4%. New Jersey's rate of uninsurance in that population is 34.8%. The report notes that the four states' initial experience with expanding their CHIP programs show that "once offered, the demand for such coverage is high and CHIP waivers can be a relatively straightforward way to implement family coverage." However, the report also notes that "increasing state budgetary stress may limit how many" additional states are able to cover parents (Howell et al., "Early Experience with Covering Uninsured Parents Under SCHIP," May 2002).