Medicaid enrollment gap length and number of Medicaid enrollment periods among US children

Am J Public Health. 2014 Sep;104(9):e55-61. doi: 10.2105/AJPH.2014.301976. Epub 2014 Jul 17.


Objectives: We examined gap length, characteristics associated with gap length, and number of enrollment periods among Medicaid-enrolled children in the United States.

Methods: We linked the 2004 National Health Interview Survey to Medicaid Analytic eXtract files for 1999 through 2008. We examined linkage-eligible children aged 5 to 13 years in the 2004 National Health Interview Survey who disenrolled from Medicaid. We generated Kaplan-Meier curves of time to reenrollment. We used Cox proportional hazards models to assess the effect of sociodemographic variables on time to reenrollment. We compared the percentage of children enrolled 4 or more times across sociodemographic groups. RESULTS. Of children who disenrolled from Medicaid, 35.8%, 47.1%, 63.5%, 70.8%, and 79.1% of children had reenrolled in Medicaid by 6 months, 1, 3, 5, and 10 years, respectively. Children who were younger, poorer, or of minority race/ethnicity or had lower educated parents had shorter gaps in Medicaid and were more likely to have had 4 or more Medicaid enrollment periods.

Conclusions: Nearly half of US children who disenrolled from Medicaid reenrolled within 1 year. Children with traditionally high-risk demographic characteristics had shorter gaps in Medicaid enrollment and were more likely to have more periods of Medicaid enrollment.

MeSH terms

  • Adolescent
  • Age Factors
  • Child
  • Child Health Services / statistics & numerical data*
  • Child, Preschool
  • Eligibility Determination
  • Female
  • Health Care Surveys
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Medicaid / statistics & numerical data*
  • Socioeconomic Factors
  • United States