The impact of the Medicaid/CHIP expansions on children: a synthesis of the evidence.
ABSTRACT This article reviews findings from 38 rigorous studies published in the peer-reviewed literature of the impact of the Medicaid/Children's Health Insurance Program (CHIP) expansions on children. There is strong evidence for increases in enrollment in public programs and reductions in uninsurance following eligibility expansions. Medicaid enrollment continued to increase during the CHIP era (a "spillover effect"). Evidence for improved access to and use of services, particularly for dental care, is also very strong. There are fewer studies of health status impacts, and the evidence is mixed. There is a very wide range in the size of effects estimated in the studies reviewed because of the methods used and the populations studied. The review identifies several important research gaps on this topic, particularly the small number of studies of the effects on health status. Both research methods and findings from the child expansions can provide insights for evaluating the coming expansions for adults under the Affordable Care Act.
- Journal of Pediatric Health Care 09/2014; · 1.97 Impact Factor
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ABSTRACT: Following the reauthorization of the Children's Health Insurance Program (CHIP) in 2009, fifteen states raised their CHIP income eligibility thresholds to further reduce uninsurance among children. We examined the impact of these expansions on uninsurance, public insurance, and private insurance among children who became newly eligible for CHIP after the expansions. Using a difference-in-differences approach, we estimated that the expansions reduced uninsurance by 1.1 percentage points among the newly eligible, cutting their uninsurance rate by nearly 15 percent. Public coverage increased by 2.9 percentage points, with variations in take-up among the states. A better understanding of these state-level differences in take-up could inform efforts to enroll children who remain uninsured but are eligible for CHIP. CHIP is up for reauthorization in 2015, and further funding will be needed to maintain the program, which provides insurance to children who might not have access to affordable private coverage.Health affairs (Project Hope). 09/2014;
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ABSTRACT: Following changes to federal cash assistance programs in 1996, low-income families now rely on a set of social programs: the Earned Income Tax Credit, food assistance, publicly funded health insurance, and child-care subsidies. In this review, we present evidence on the effects of these programs on families' economic circumstances, families' psychological well-being and functioning, and children's developmental outcomes. Social safety net programs improve families' economic circumstances, thereby achieving their primary goal. Few studies have examined impacts on children's developmental outcomes but overall, programs improve children's academic, behavioral, and physical well-being. Even fewer studies have examined impacts on parents' psychological well-being or family functioning, leaving gaps in the literature. The review concludes with discussions of the Great Recession and whether effects found during stronger economic times generalize to the most recent economic crisis, and with a discussion of social safety net policies in countries outside the United States.Child Development Perspectives 09/2013; 7(3). · 1.56 Impact Factor