The devil may be in the details: how the characteristics of SCHIP programs affect take-up

J Policy Anal Manage. 2005 Summer;24(3):499-522. doi: 10.1002/pam.20112.


In this paper, we explore whether the specific design of a state's program has contributed to its success in meeting two objectives of the Children's Health Insurance Program (SCHIP): increasing the health insurance coverage of children in lower income families and doing so with a minimum reduction in their private health insurance coverage (crowd-out). In our analysis, we use two years of Current Population Survey data, 2000 and 2001, matched with detailed data on state programs. We focus on two populations: the eligible population of children, broadly defined--those living in families with incomes below 300 percent of the federal poverty line (FPL)--and a narrower group of children, those who we estimate are eligible for Medicaid or SCHIP. Unique state program characteristics in the analysis include whether the state plan covers families; whether the state uses presumptive eligibility; the number of months without private coverage that are required for eligibility; whether there is an asset test; whether a face-to-face interview is required; and specific outreach activities. Our results provide evidence that state program characteristics are significant determinants of program success.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Child
  • Child Health Services / statistics & numerical data*
  • Community-Institutional Relations*
  • Demography
  • Eligibility Determination / statistics & numerical data
  • Government Programs / statistics & numerical data*
  • Humans
  • Insurance Coverage / statistics & numerical data*
  • Interviews as Topic
  • Medicaid / statistics & numerical data
  • Medically Uninsured / statistics & numerical data
  • Poverty
  • Private Sector
  • Program Evaluation*
  • Public Sector
  • State Government
  • United States