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.

The area of government property asset management is relatively new in public management. Most public wealth is concentrated in public property, and expenses associated with it constitute a substantial part of public budgets. The chapter ventures into two international "hot topics": practical enhancement of public financial resources through better management of property asset and curbing corruption in the historically corrupt area of government-owned property. The chapter provides a conceptual and methodological framework for governmental decision-makers and their advisors and ends by formulating and discussing a number of issues that require further professional and public debate.

The Urban Institute worked with five cities in post-Soviet Kyrgyzstan to apply better management practices through the development of Strategic Land Management Plans. UI worked with local governments to make an inventory of municipal land, publicize the results, and develop a strategy that articulated principles for land management. This led to several improvements including proper registration of parcels and proactive policies to lease and sell land through open competition. It also established a model for determining public policy that countered corruption and public deliberation of costs and benefits in the use of local assets. Donor involvement was also critical to success.

Many of Massachusetts's health reforms have brought about positive change: the number of uninsured has fallen by half, access to needed care has increased, and private insurance has not been "crowded out" by public insurance programs. But the Massachusetts initiative has also seen higher than anticipated costs. In a new analysis, John Holahan and Linda Blumberg summarize the state's accomplishments, examine the challenges, and suggest four options for addressing long-term costs. According to the authors, much of Massachusetts's high spending growth is due to the concentration in the state's hospital and insurance markets.

Between increased Medicaid caseloads, rising indigent care costs, and Medicaid's share of state revenue losses, an economic downturn in the next two and a half years could impose between $74 billion and $118 billion in extra financial burdens on the 50 states, if unemployment averages between 8 and 10 percent. The amount Congress must spend to prevent state service cutbacks and tax increases depends on how fiscal relief is allocated. Basing each state's funding on objective, economic indicators makes federal dollars go farther towards solving state fiscal woes, since more of the money benefits the states that most need help.

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.

In FY 2007, the national child support program served 17 million children and collected $25 billion in child support, yet little is known about the underlying demographic and economic characteristics of the individuals served. To remedy this lack of information, Courtland Consulting and the Urban Institute, under contract with the federal Office of Child Support Enforcement, surveyed nine state child support programs about their caseloads. We found that state child support programs are able to provide considerable amounts of information about their clients, but key characteristics proved difficult to obtain, such as the poverty status of the families served.

Nonprofits and businesses interact in more and newer ways every year as powerful economic and social forces change. Nonprofits adopt more business-like practices, corporations support nonprofits through cause-related marketing, and social entrepreneurs create private businesses to achieve social goals. Nonprofits and Business, a new Urban Institute Press book, explores these and many other ways the two sectors collaborate, compete, and clash.

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.

Unlike most previous recessions, the current economic slowdown has substantially increased the unemployment rate for older Americans. In December 2008, 5.1 percent of workers age 65 and older were unemployed, a higher share than at any time since March 1977. This factsheet provides the latest information on the employment situation of older Americans.