CHIP

You are currently browsing articles tagged CHIP.

Does expanding insurance coverage improve access to care?

February 27, 2012 in CHIP, Health Reform, Medicaid | 3 comments

Although Health Reform did little to reduce the cost of health care, it did make significant strides to expand access to care.  For low-income individuals, the increased access comes along two dimensions: expanded Medicaid eligibility and increased physician fees.  Specifically, Health Reform required to

  • Make all individuals with incomes below 138% of the Federal Poverty Line (FPL) eligible for Medicaid, and
  • Increase their Medicaid physician fee schedules, so that they are no lower than Medicare’s for evaluation and management services provided by primary care physicians.

Whereas the first provision is permanent, the second provision is to be in effect only for 2013 and 2014.

Which one will have a bigger effect? According to a paper by White (2012), paying doctors more improves access.

Read the rest of this entry »

Tags: , , , ,

State Governments Providing Health Insurance to More Children

October 28, 2011 in CHIP, HC Statistics, Medicaid | No comments

Of the 6.6 million uninsured children in the nation, 4.3 million are eligible for Medicaid or the Children’s Health Insurance Program (CHIP). Approximately 2.8 million children come from families at or near the federal poverty line (FPL).

Despite the fact that millions of children are uninsured, children’s participation rates in Medicaid/CHIP are increasing. Today I will review the results of an Urban Institute study examining trends in Medicaid participation rates for children.

Data

The authors use data from the 2008 and 2009 American Community Survey (ACS). This large survey data set has replaced the Census long form. The authors use the Integrated Public Use Microdata Series (IPUMS) version of the ACS.

Determining Eligibility

Three main characteristics determine a child’s eligibility: family composition, income, and immigration status.  Medicaid eligibility depends on the family’s income as a share of the federal poverty level (FPL).  The FPL threshold changes based on how many individuals are in the household.  Further, many States restrict Medicaid and CHIP access to citizens or legal residents.  Although survey data often indicate whether the individual is foreign born, the data do not contain information on whether the individual is a citizen, legal resident, temporary resident, or lives in the U.S. illegally.  This paper describes one methodology to impute immigration status from these survey data.

Results

  • The share of children without health insurance coverage fell between 2008 and 2009,despite the ongoing economic downturn;
  • Nationally, the rate of Medicaid/CHIP participation among children rose by 2.7 percentage points to 84.8 percent and cross-state variation in Medicaid/CHIP participation rates narrowed, as larger improvements occurred on average for states that had the lowest participation rates in 2008;
  • Six states (DC, Hawaii, Maine,Massachusetts, Michigan and Vermont) had participation at or above 90.0 percent in 2008 and 2009
  • Six states (Florida, Montana, Nevada, North Dakota, Texas and Utah) had participation rates below 80.0 percent in both 2008 and 2009
  • Participation gains occurred between 2008 and 2009 for children in each race/ethnicity, language, income and age group examined;

Source: Kenney GM, Lynch V, Haley J, Huntress M, Resnick D and Coyer C. “Coverage Gains for Children,” Urban Institute, RWJF Report, Aug 16, 2011.

Tags: , , , , , ,

Safety Net Patients in California

October 21, 2010 in CHIP, HC Statistics, Health Insurance, Medicaid | No comments

The California Health Care Foundation (CHCF) reviews how California’s safety net residents receive medical care.  Safety Net patients are considered those who have incomes below 300% of the federal poverty line.  Below is a list of governmental and non-governmental programs which serve California Safety Net residents.

This graph shows public program eligibility by poverty level for different types of residents.  These eligibility levels are from 2009 and will change once health reform is implemented.  In particular, Medi-Cal will be extended to more individuals.

One interesting point is that while adults with children are currently eligible for Medi-Cal if their income is below the poverty line, adults without children can only receive subsidized medical services through county programs.

Tags: , , , ,

Explaining CHIPRA

June 9, 2010 in Medicaid/Medicare | 1 comment

In spring of 2009, the federal government passed the Children’s Health Insurance Program Reauthorization Act or CHIPRA.  The Children’s Health Insurance Program (CHIP), formerly known as the State Children’s Health Insurance Program (CHIP) provides health insurance to low income children. Like Medicaid, it is federally mandated, but state run. Some states provide health insurance for kids through existing Medicaid programs while others have created a separate insurance scheme. The eligibility of kids for CHIP is more generous (as judged by FPL) than Medicaid.

Two sources have good reviews of the new provisions that were added to CHIP in the Reauthorization Act of 2009.  I have also made this table which summarizes these new CHIP  provisions in the bill.

Tags: ,

Explaining how Health Reform will alter Medicaid and CHIP

June 7, 2010 in CHIP, Medicaid, Public Policy | 1 comment

Health Reform, also known as the Patient Protection and Affordable Care Act (PPACA), drastically altered the health care landscape.  Congress included health exchanges, and individual mandate, and a number of other reforms into the bill.  Today, I focus on how Health Reform will affect existing programs which care for the nations poor.  In particular, CHIP funds medical care for many of the nation’s youth and Medicaid provides health insurance coverage to low-income Americans.  Both programs operate under a federal mandate, but are run at the state level.  The Kaiser Family Foundation outlines the Health Reform provisions that will alter both the Medicaid and CHIP programs.

To summarize these findings, I have created the following table.

Tags: , , ,

Eligibility Requirement for California Government Health Insurance Programs

January 19, 2010 in Medicaid/Medicare, Public Health, Public Policy | No comments

The California HealthCare Foundation has an almanac entry on Children’s Health Coverage Facts and Figures.  Eligibility requirements for these programs is described in this table.  Other key findings include:

  • The proportion of children without health insurance continued to decline through 2007, though the pace of improvement has slowed.
  • Nearly 80 percent of California’s uninsured children are eligible for coverage under either Medi-Cal, Healthy families, or Healthy Kids.
  • Medi-Cal and Healthy families are key sources of coverage for children in low-income households that together have closed the coverage gap among families with incomes up to 250 percent of the federal poverty level.
  • Healthy Kids programs are also important for children’s coverage. twenty-four counties operate Healthy Kids programs and four others rely on California Kids.
  • Children are less likely to have employment-based coverage than adults and are more likely to be enrolled in public programs in California.

Tags: , , , , ,