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Discontinuity of Coverage for Medicaid and S‐CHIP Children at a Transitional Birthday
Author(s) -
Ketsche Patricia,
Adams E. Kathleen,
Snyder Angela,
Zhou Mei,
Minyard Karen,
Kellenberg Rebecca
Publication year - 2007
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2007.00795.x
Subject(s) - medicaid , public health insurance , medicine , demography , cohort , ethnic group , regression discontinuity design , public assistance , health insurance , gerontology , health care , economic growth , political science , economics , welfare , pathology , sociology , law
Research Objective. To investigate disenrollment from public insurance at the 6‐year transitional birthday when eligibility for many children moves from Medicaid to State Children's Health Insurance Program (S‐CHIP). Data Sources. Data from Georgia's S‐CHIP (PeachCare) and Medicaid programs from 2000 to 2002. Study Design. The likelihood of dropping public coverage after the reference birthday is modeled for children turning age 6 compared with a control cohort of children turning age 9 controlling for demographic and geographic differences between enrollees. Principal Findings. Over 17 percent of 6‐year‐olds versus only 7 percent of the control cohort dropped coverage. After controlling for other factors (e.g., race/ethnicity, prior enrollment, and geographic region) having lower historical expenditures is predictive of dropping coverage among all children, although the unadjusted effect is stronger among children enrolled in PeachCare before their sixth birthday. Only 1 percent of Medicaid children who remained covered transitioned to PeachCare. Conclusions. Turnover at transitional birthdays identifies a common pathway for children into the ranks of the uninsured. Facilitating continuous enrollment would retain in the programs children with lower than average expenditures. This may be one of the more cost effective ways of reducing the number of uninsured children in Georgia.