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The Impact of the Children’s Health Insurance Program (CHIP): What Does the Research Tell Us?

Issue Brief
  1. http://kff.org/other/state-indicator/annual-chip-enrollment/

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  2. Laura Snyder et al., Medicaid Enrollment Snapshot: December 2013, and Vernon Smith, Laura Snyder, and Robin Rudowitz, CHIP Enrollment Snapshot: December 2013 (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, June 2014), http://kff.org/medicaid/issue-brief/medicaid-enrollment-snapshot-december-2013/ and http://kff.org/medicaid/issue-brief/chip-enrollment-snapshot-december-2013/

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  3. Robin Rudowitz, Samantha Artiga, and Rachel Arguello, Children’s Health Coverage: Medicaid, CHIP and the ACA (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, March 2014), http://kff.org/health-reform/issue-brief/childrens-health-coverage-medicaid-chip-and-the-aca/

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  4. Margo Rosenbach et al., National Evaluation of the State Children’s Health Insurance Program: A Decade of Expanding Coverage and Improving Access – Final Report (Mathematica Policy Research, Inc., for Centers for Medicare and Medicaid Services, September 2007), http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/Reports/downloads/rosenbach9-19-07.pdf 

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  5. Rudowitz et al., op.cit. and “Children’s Health Insurance Program (CHIP): Accomplishments, Challenges, and Policy Recommendations,” Pediatrics 133(3), January 2014, http://pediatrics.aappublications.org/content/133/3/e784.full.pdf+html?sid=a7870594-5581-44a9-a69a-fc79e724e8e0

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  6. Genevieve M. Kenney, Nathaniel Anderson, and Victoria Lynch, Medicaid/CHIP Participation Rates among Children: An Update (Urban Institute, September 2013), http://www.urban.org/research/publication/medicaidchip-participation-rates-among-children-update

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  7. Rosenbach et al., op.cit.

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  8. See Rudowitz et al., op.cit. (KCMU/Urban Institute analysis of 2013 ASEC Supplement to the CPS)

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  9. Amy Davidoff, Alshadye Yemane, and Ian Hill, “Public Insurance Eligibility and Enrollment for Special Health Care Needs Children,” Health Care Financing Review 26(1), Fall 2004, https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/downloads/04fallpg119.pdf

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  10. Benefits and Cost Sharing in Separate CHIP Programs (Georgetown University Institute for Health Policy, Center for Children and Families, May 2014), http://ccf.georgetown.edu/ccf-resources/benefits-and-cost-sharing-in-separate-chip-programs/

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  11. Julia Paradise, Children and Oral Health: Assessing Needs, Coverage, and Access (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, June 2012), http://kff.org/disparities-policy/issue-brief/children-and-oral-health-assessing-needs-coverage/

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  12. Federal law now requires parity between mental and physical health benefits in CHIP programs that cover any mental health services.

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  13. Leighton Ku and Matthew Broaddus, “Public and Private Health Insurance: Stacking up the Costs,” Health Affairs 27(4), 2008, http://content.healthaffairs.org/content/27/4/w318.full.pdf+html?sid=5e816db3-7247-4774-88b8-cfffbc7fb814

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  14. Children’s Health Insurance: Information on Coverage of Services, Costs to Consumers, and Access to Care in CHIP and Other Sources of Insurance (Government Accountability Office, November 2013), http://www.gao.gov/products/gao-14-40

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  15. Tricia Brooks, Martha Heberlein, and Joseph Fu, Dismantling CHIP in Arizona: How Losing KidsCare Impacts a Child’s Health Care Costs, (Center for Children and Families, Georgetown University Health Policy Institute, May 2014), http://ccf.georgetown.edu/ccf-resources/dismantling-chip-in-arizona-how-losing-kidscare-impacts-a-childs-health-care-costs/

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  16. Lisa Dubay and Genevieve Kenney, “Health Care Access and Use among Low-Income Children: Who Fares Best?” Health Affairs 20(1), January 2001, http://content.healthaffairs.org/content/20/1/112.full

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  17. Embry Howell and Genevieve Kenney, “The Impact of the Medicaid/CHIP Expansions on Children: A Synthesis of the Evidence,” Medical Care Research and Review 69(4), August 2012, http://www.ncbi.nlm.nih.gov/pubmed/22451618

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  18. Thomas Selden and Julie Hudson, “Access to Care and Utilization among Children: Estimating the Effects of Public and Private Coverage,” Medical Care 44(5), May 2006, http://www.jstor.org/discover/10.2307/3768354?uid=3739584&uid=2&uid=4&uid=3739256&sid=21104273043357

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  19. Genevieve Kenney and Christine Coyer, National Findings on Access to Health Care and Service Use for Children Enrolled in Medicaid or CHIP  (MACPAC Contractor Report No. 1, March 2012), http://www.urban.org/research/publication/national-findings-access-health-care-and-service-use-children-enrolled-medicaid

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  20. Howell and Kenney, op. cit.

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  21. “CHIP Accomplishments, Challenges, and Policy Recommendations,” op.cit.

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  22. Rosenbach et al., op. cit.

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  23. Andrew Dick et al., “SCHIP’s Impact in Three States: How Do the Most Vulnerable Children Fare?” Health Affairs 23(5) Sept-Oct 2004, http://content.healthaffairs.org/content/23/5/63.full

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  24. Laura Shone et al., “Reduction in Racial and Ethnic Disparities After Enrollment in the State Children's Health Insurance Program,” Pediatrics 115(6), June 2005, http://pediatrics.aappublications.org/content/115/6/e697.long

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  25. 2013 Annual Report on the Quality of Care for Children in Medicaid and CHIP (U.S. Department of Health and Human Services, September 2013), http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Downloads/2013-Ann-Sec-Rept.pdf

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  26. 2012 Annual Report on the Quality of Care for Children in Medicaid and CHIP (U.S. Department of Health and Human Services, December 2012), http://www.medicaid.gov/Medicaid-CHIP-Program-Information/By-Topics/Quality-of-Care/Downloads/2012-Ann-Sec-Rept-ES.pdf

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  27. Kenney and Coyer, op. cit.

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  28. Ibid.

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  29. Asheley Cockrell Skinner and Michelle Mayer, “Effects of Insurance Status on Children’s Access to Specialty Care: A Systematic Review of the Evidence,” BMC Health Services Research (7), 2007, http://www.biomedcentral.com/1472-6963/7/194%20?iframe=true&width=100%&height=100%

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  30. Joanna Bisgaier and Karin Rhodes, “Auditing Access to Specialty Care for Children with Public Insurance,” New England Journal of Medicine 364(24), June 6, 2011, http://www.nejm.org/doi/full/10.1056/NEJMsa1013285

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  31. Joanna Bisgaier et al., “Disparities in Child Access to Emergency Care for Acute Oral Injury,” Pediatrics 127(6), June 2011, http://www.ncbi.nlm.nih.gov/pubmed/21606154

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  32. MEDICAID AND CHIP: Most Physicians Serve Covered Children but Have Difficulty Referring Them for Specialty Care (Government Accountability Office, June 2011), http://www.gao.gov/products/GAO-11-624

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  33. Hua Wang, Edward Norton, and R. Gary Rozier, “Effects of the State Children’s Health Insurance Program on Access to Dental Care and Use of Dental Services,” Health Services Research 42 (4), August 2007, http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1955282/

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  34. Paradise, op. cit.

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  35. 2012 and 2013 Annual Report on Quality of Care for Children, op. cit.

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  36. 2013 Annual Report on Quality, op. cit.

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  37. Kenney and Coyer, op. cit.

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  38. Paradise, op.cit.

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  39. Hao Yu et al., “Role of SCHIP in Serving Children with Special Health Care Needs,” Health Care Financing Review 28(2), Winter 2006-2007, http://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/downloads/06-07Winpg53.pdf

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  40. Szilagyi P et al., “Improved Asthma Care After Enrollment in the State Children’s Health Insurance Program in New York,” Pediatrics 117(2), February 2006, http://pediatrics.aappublications.org/content/117/2/486.long

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  41. N. Menachemi et al., “The Impact of CHIP Coverage on Children with Asthma in Alabama,” Clinical Pediatrics 51(3), March 2012, http://www.ncbi.nlm.nih.gov/pubmed/21890839

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  42. Peter Szilagyi et al., “Improved Health Care Among Children with Special Health Care Needs After Enrollment in the State Children’s Health Insurance Program,” Ambulatory Pediatrics 7(1), January-February 2007, http://www.ncbi.nlm.nih.gov/pubmed/17261477

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  43. Kenney and Coyer, op.cit.

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  44. Most Physicians Serve Covered Children, op. cit.

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  45. ORAL HEALTH: Efforts Under Way to Improve Children’s Access to Dental Services, but Sustained Attention Needed to Address Ongoing Concerns (Government Accountability Office, November 2010), http://www.gao.gov/assets/320/312818.pdf

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  46. Howell and Kenney, op.cit.

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  47. D. Bermudez and L. Baker, “The Relationship between SCHIP Enrollment and Hospitalizations for Ambulatory Care Sensitive Conditions in California, Journal of Health Care for the Poor and Underserved 16(1), 2005, http://www.ncbi.nlm.nih.gov/pubmed/15741712

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  48. Leemore Dafny and Jonathan Gruber, “Public Insurance and Child Hospitalizations: Access and Efficiency Effects,” Journal of Public Economics 89, 2005, http://economics.mit.edu/files/6435

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  49. Robert Kaestner, Theodore Joyce, and Andrew Racine, “Medicaid Eligibility and the Incidence of Ambulatory Care Sensitive Hospitalizations for Children,” Social Science & Medicine 52, 2001, http://www.ncbi.nlm.nih.gov/pubmed/11144786

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  50. Embry Howell et al., “Declining Child Mortality and Continuing Racial Disparities in the Era of the Medicaid and SCHIP Insurance Coverage Expansions,” American Journal of Public Health 100(12), December 2010, http://ajph.aphapublications.org/doi/abs/10.2105/AJPH.2009.184622

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  51. Bill Wright and Heidi Allen, Healthy Kids Evaluation Study: Results from the 12-Month Follow-Up Survey (Office for Oregon Health Policy and Research, Oregon Health Authority, September 2012), http://www.oregon.gov/oha/OHPR/RSCH/docs/Uninsured/HealthyKids_EnrolleeStudy_Followup_Report.pdf

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  52. The Healthy Families Program Health Status Assessment (PedsQLTM) - Final Report (California Managed Risk Medical Insurance Board, September 2004), http://www.mrmib.ca.gov/mrmib/HFP/PedsQL3.pdf

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  53. Leighton Ku, Mark Lin, and Matt Broaddus, Chartbook: Improving Children’s Health – The Roles of Medicaid and SCHIP (Center on Budget and Policy Priorities, January 2007), http://www.cbpp.org/cms/index.cfm?fa=view&id=1296

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  54. Sarah Cohodes et al., The Effect of Child Health Insurance Access on Schooling: Evidence from Public Insurance Expansions (National Bureau of Economic Research, May 2014), http://www.nber.org/papers/w20178

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  55. Informing CHIP and Medicaid Outreach and Education – Topline Report: Key Findings from a National Survey of Low-Income Parents, (Centers for Medicare and Medicaid Services, November 2011),

    http://www.insurekidsnow.gov/professionals/chip-medicaid-survey-topline.pdf

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  56. Parents’ View of CHIP and Medicaid: Snapshot of Findings from a Survey of Low-Income Parents, presentation by Michael Perry, Lake Research Partners, National Children’s Health Summit, November 2011, http://www.insurekidsnow.gov/professionals/events/2011_conference/2nd_national_children_s_health_insurance_summit_
    opening_plenary_michael_perry.pdf.pdf

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  57. Michael Perry and Julia Paradise, Enrolling Children in Medicaid and SCHIP: Insights from Focus Groups with Low-Income Parents (Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, May 2007), https://kaiserfamilyfoundation.files.wordpress.com/2013/01/7640.pdf

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