How Well Is CHIP Addressing Health Care Access and Affordability for Children?

Acad Pediatr. May-Jun 2015;15(3 Suppl):S71-7. doi: 10.1016/j.acap.2015.02.007. Epub 2015 Mar 29.


Objective: We examine how access to care and care experiences under the Children's Health Insurance Program (CHIP) compared to private coverage and being uninsured in 10 states.

Methods: We report on findings from a 2012 survey of CHIP enrollees in 10 states. We examined a range of health care access and use measures among CHIP enrollees. Comparisons of the experiences of established CHIP enrollees to the experiences of uninsured and privately insured children were used to estimate differences in children's health care.

Results: Children with CHIP coverage had substantially better access to care across a range of outcomes, other things being equal, particularly compared to those with no coverage. Compared to being uninsured, CHIP enrollees were more likely to have specialty and mental health visits and to receive prescription drugs; and their parents were much more likely to feel confident in meeting the child's health care needs and were less likely to have trouble finding providers. CHIP enrollees were less likely to have unmet needs, but 1 in 4 had at least 1 unmet need. Compared to being privately insured, CHIP enrollees had generally similar health care use and unmet needs. Additionally, CHIP enrollees had lower financial burden related to their health care needs. The findings were generally robust with respect to alternative specifications and subgroup analyses, and they corroborated findings of previous studies.

Conclusions: Enrolling more of the uninsured children who are eligible for CHIP improved their access to a range of care, including specialty and mental health services, and reduced the financial burden of meeting their health care needs; however, we found room for improvement in CHIP enrollees' access to care.

Keywords: CHIP; access and use of health care; affordability; comparison of health insurance coverage types; emergency department visit; health insurance adequacy; mental health visit; prescribed medicine; public health insurance; specialist care; unmet health care needs.

Publication types

  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Child Health Services / economics*
  • Child Health Services / statistics & numerical data
  • Child, Preschool
  • Children's Health Insurance Program*
  • Cost Sharing*
  • Female
  • Health Expenditures*
  • Health Services Accessibility*
  • Humans
  • Infant
  • Insurance Coverage
  • Male
  • Medically Uninsured*
  • Mental Health Services / economics
  • Mental Health Services / statistics & numerical data
  • United States