Related UI Researchers

Publications on Children

With the reauthorization of the State Children’s Health Insurance Program (SCHIP) under consideration in early 2009, an important question is the extent to which uninsured children could be covered under employer-sponsored insurance (ESI) through premium assistance programs. Only 440,000 uninsured children who are eligible for Medicaid or SCHIP have at least one parent with ESI coverage. Since many more uninsured children are eligible for public programs than have access to ESI through their parents, policies to increase enrollment and retention in Medicaid and SCHIP have much greater potential than premium assistance programs to close coverage gaps among children.

In September 2007, child support arrears had reached $107 billion. The purpose of this report is to provide information about the individuals who owe child support arrears, estimate how much arrears are likely to be collected, and identify the factors that have led to their rapid growth. We find that most arrears are owed by noncustodial parents who have no or low reported incomes. We estimate that 40 percent of arrears in seven large states are likely to be collected over 10 years. The primary reason arrears have grown is because many states have begun to assess interest on arrears.

This comparative case study describes the organization, delivery, and content of care of three maternity care models serving low-income women at risk of poor birth outcomes in Wards 5, 6, and 7 in Washington D.C. The first model, a birth center, provides prenatal care, birth services, postpartum follow-up, and infant and child health care. The second is a safety net clinic, which provides a variety of primary health care services, as well as prenatal care services. A not-for-profit teaching and research hospital represents a third option in which prenatal and postnatal care is provided through an on-site obstetric clinic.

As the reauthorization of the State Children's Health Insurance Program (SCHIP) and broader health care reform efforts are considered, important policy questions include where eligibility thresholds should be set for public coverage and how much latitude states should have in setting their thresholds. This analysis shows that employer-sponsored insurance premiums are less affordable for families at 300 percent of the FPL now than they were for families at 200 percent of the FPL in 1996, particularly in areas with a high cost of living and suggests the need to adjust eligibility thresholds for growth in health care costs.

The authors use variation across states and over time in managed care (MC) programs for publicly insured children to examine whether effects differ for children with chronic health conditions (CWCHC) and those without. The authors pool data from the 1997 to 2002 National Health Interview Survey and link county, year, and health status information on type of MC programs implemented. Findings show that the effects of MC are concentrated on CWCHC and that CWCHC experience reductions in use of specialist, mental health, and prescription drugs. Capitated programs with mental health or specialty carve-outs are associated with a greater number and larger decreases in service use compared to integrated capitated programs. While it is not possible to determine whether MC programs resulted in more appropriate use of services, corresponding reductions in perceived access were not observed, suggesting that net effects of MC on service use represent improvements in care coordination.