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Health Insurance and Access to Care for Children and Adolescents
Knowledge Path

Introduction

This knowledge path about child and adolescent health insurance and access to care has been compiled by the MCH Library at Georgetown University. It offers a selection of current, high-quality resources for professionals (health professionals, program administrators, policymakers, and researchers) that analyze data, describe effective programs, and report on policy and research aimed at advancing health coverage and improving health care access for children and adolescents. Emphasis is placed on Medicaid and the Children's Health Insurance Program (CHIP). Separate sections present resources about health reform and outreach and enrollment. Separate briefs point to resources for families and schools. This knowledge path will be updated periodically.

Please note: The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 extends and expands the State Children's Health Insurance Program (SCHIP) enacted in 1997. CHIPRA refers to the program as CHIP, not SCHIP. Several publications in this knowledge path were published before CHIPRA was signed into law, and therefore, use the acronym SCHIP.

Overview

See Covering Health Issues, 5th ed (2010), a briefing book by the Alliance for Health Reform. Chapter 6 addresses children's health coverage and offers facts, background information, policy debate summaries, tips and story ideas for reporters covering this topic, and a list of experts with contact information.

Resources for Professionals

Websites

Additional Electronic Publications

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about health insurance and access to health care for children and adolescents. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data
  • ChildStats.gov. Data and reports about children and families, including family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. View statistics about health insurance coverage and source of health care. ChildStats.gov is a service of the Federal Interagency Forum on Child and Family Statistics.

  • Data Resource Center for Child and Adolescent Health (DRC). Data from the National Survey of Children's Health and the National Survey of Children with Special Health Care Needs. View national and state data on over 100 indicators of child health and well-being, including health insurance coverage and access to health care services. DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI). View background information about the data-collection mechanism, State and Local Area Integrated Telephone Survey (SLAITS), along with additional data and survey modules.

  • Healthcare Cost and Utilization Project (HCUP): HCUPnet. Data on hospital inpatient and emergency department utilization at the national and state levels, including use of hospitals by children and hospital stays by payer (e.g., Medicaid, private insurance, uninsured). HCUP is an initiative of the Agency for Healthcare Research and Quality (AHRQ).

  • KIDS COUNT Data Center. National and state data to track the status of infants, children, and adolescents in the United States. Data categories include demographics, education, economic well-being, health (includes health insurance coverage), family and community, vital statistics, and indicators by race and ethnicity. KIDS COUNT is a project of the Annie E. Casey Foundation (AECF).

  • Medical Expenditure Panel Survey (MEPS). Data on the cost and use of health care and health insurance coverage from large-scale surveys of families and individuals, their medical providers, and employers across the United States. MEPS is sponsored by the Agency for Healthcare Research and Quality (AHRQ).

  • National Health Interview Survey. National data on a broad range of health topics including health insurance coverage and access to health care. The survey is sponsored by the National Center for Health Statistics.

  • National Quality Measures Clearinghouse™ (NQMC). Evidence-based health care quality measures and measure sets for physicians, hospitals, and health plans to evaluate and improve the quality of health care for consumers. Identify measures on this topic by clicking on Detailed Search and entering insurance, health OR health services accessibility in the Keyword field of the search form. Under Age Range, select the categories for adolescent, child, and infant. Hold down the control key (ctrl) or Apple command key and click your mouse to make multiple selections. Click on Search to get your results. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).

  • statehealthfacts.org. State-level data on demographics, health status, health coverage and the uninsured, Medicaid and CHIP, health costs and budgets, Medicare, managed care and health insurance, providers and service use, minority health, women's health, and HIV/AIDS. Information is displayed as bar graphs, tables, or color-coded maps. View individual state profiles or compare data for all states by category. statehealthfacts.org is a project of the Kaiser Family Foundation. Kaiser also offers customizable state Medicaid fact sheets. For detailed information about the Medicaid benefit packages in each state, see Kaiser's Medicaid Benefits Online Database.

  • State Health Access Data Assistance Center (SHADAC): Data Center. Health insurance coverage estimates from the Current Population Survey's Annual Social and Economic Supplement (CPS) and the American Community Survey (ACS). Customize tables of health insurance coverage estimates within a pre-defined set of parameters (i.e., by state or nationally, by year, by age range, and/or by poverty status).

  • Title V Information System (TVIS). Data from annual Title V Block Grant applications and reports submitted by all 59 U.S. states and jurisdictions. To identify information on the topic, conduct several searches. Select Program Data and view data reports in the sections, Individuals Served, Medicaid/Non Medicaid Comparison, and Medicaid and CHIP Eligibility. Also select Measurement and Indicator Data and click on National Performance Measures to select and view data about national goals for providing children and adolescents with health insurance and access to health care in each state. Next, select Measurement and Indicator Data and State Priority Needs Keyword Search. Select the keywords, Access to Health Care and Insurance, from the list (each term must be searched separately). Add Population (e.g., adolescents, children, infants) to the keyword search. The selections, State Performance Measures and State Outcome Measures also provide information about how states are addressing this issue. TVIS is a service of the Maternal and Child Health Bureau (MCHB). Also see MCHB's Discretionary Grant Information System (DGIS).

  • Also see the Catalyst Center chartbook and the data analyses and resources of the Census Bureau.
Literature and Research Databases
  • MCH Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Databases to collect, manage, and disseminate knowledge about maternal and child health (MCH), with special emphasis on knowledge gained from initiatives and programs supported by the Maternal and Child Health Bureau (MCHB). The library's bibliographic database is

    MCHLine®. Online catalog of materials in the MCH Library with many items about this topic. Conduct two separate searches in the keyword field of the database search form using the terms "health insurance" and "access to health care" Narrow your searches by adding a publication year or range of years. Selections of recent items are listed in the bibliography Outreach Programs and Strategies.

    Also see the MCH Organizations Database and the MCH Projects Database.

  • PubMed. Over 20 million citations for biomedical articles from MEDLINE and life science journals. Citations may include links to full-text articles from PubMed Central or publisher websites. To identify citations on the topic, enter the phrase insurance, health OR health services accessibility in the search box. Click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; click on Ages: All Child; and select Search Field Tags: MeSH Major Topic. Click on Search to get your results. To narrow your search further or for additional searches, use the MeSH (Medical Subject Headings) database to identify terms (e.g., Medicaid, medically uninsured). PubMed is a service of the National Library of Medicine (NLM).
Programs Databases
  • Community Pediatrics Grants Database. Archive of community pediatrics grant projects. Identify projects by selecting a topic (e.g., Access/Barriers to Health Care, SCHIP Outreach). The database is a service of the American Academy of Pediatrics (AAP).

  • Discretionary Grant Information System (DGIS). Information about more than 900 grants issued by the Maternal and Child Health Bureau (MCHB). To identify grant information on the topic, select Abstracts and click on Advanced Search. Enter keywords, such as access to health care, insurance, Medicaid (each term must be searched separately and there will be some overlap in search results). Refine your searches by adding information to the other categories on the search form. Click on Search to get your results. To find products and publications produced by MCHB training grantees, select Program Data; select Training; select Search Products and Publications; and select Advanced Search. Enter keywords, such as access to health care, insurance, Medicaid (each term must be searched separately and there will be some overlap in search results). Select a type of publication or publication year(s) to narrow your search. Click on Search to get your results.

  • First Focus: ChildrensBudget.org. Annual funding information for each federally supported program that benefits children. For information about health programs, go to the box, Search Programs. Under Policy Area/Category, select Health. Click on Search Programs.

  • Health Services Research Projects in Progress (HSRProj). Information about ongoing health services research and public health projects. To identify projects on the topic, click on Advanced Search. Enter the search phrase (child OR adolescent) AND (insurance, health OR health services accessibility). Select project date ranges, project status, and/or a state to narrow your search. Click on Search to get your results. Try other search terms, such as Medicaid or medically uninsured. HSRProj is funded by the National Library of Medicine (NLM).

  • MCH Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University.

    MCH Organizations Database. Information about more than 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. Find organizations focusing on the topic by conducting two separate searches in the database using the terms "health insurance" and "access to health care" in the keyword field of the database search form. There will be some overlap in the records identified in these searches.

    MCH Projects Database. Online catalog of projects funded by the Maternal and Child Health Bureau (MCHB) through October 1, 2002. To identify projects about child health insurance and access to health care, conduct three searches using the terms "health insurance", "access to health care", and "healthy tomorrows" in the abstract field of the database search form. There will be some overlap in the records identified in these searches. Also see MCHB's Discretionary Grant Information System (DGIS) and the Healthy Tomorrows projects, which focus on linking together the resources that children need to access health services.

  • Medicaid Benefits Online Database. Information about benefits covered, populations served, and the limitations, co-payments, and reimbursement policies that apply to Medicaid benefits for all 50 states, the District of Columbia, and U.S. territories. This database is a service of the Kaiser Family Foundation (KFF).

  • State Coverage Initiatives (SCI): Coverage By State. Click on a state to find out about the state's health coverage programs and coverage strategies.

News and Commentary

  • Center for Children and Families: Say Ahhh! A Children's Health Policy Blog. This blog focuses on expanding affordable health insurance coverage options for children and families. The left sidebar lists other health policy blogs.

  • Commonwealth Fund: Newsletters. This collection of newsletters addresses health reform, health care quality, state health policy, federal health policy, and newly released Commonwealth Fund resources. The Commonwealth Fund Blog presents analysis and commentary about health reform and other pressing health policy issues.

  • Families USA: State Health Beat. This electronic newsletter reports on the activities of state health care advocates. The Stand Up for Health Care blog offers analysis and commentary about health reform, children's health, Medicaid, and other health policy topics. Also sign up for the Health Action Network for e-mail updates with information and action steps on Medicaid, Medicare, children's health, private insurance, and other important health care developments.

  • Kaiser Health News. Coverage of health policy issues and developments at the federal and state levels and trends in the delivery of health care and in the marketplace. Presents daily summaries of major health care news from across the nation, as well as original videos and a broad range of commentary on topics that include health reform, Medicaid, and the uninsured.

Special Topics

Health Reform

This is a selection of the many health reform resources available electronically. This collection includes several websites that address health reform measures related to children and adolescents and several websites that provide coverage and analysis of federal and state health reform activities. Many of the websites listed in the General Resources for Professionals section also address health reform as noted in the website description for each.

Outreach and Enrollment

Resources for Families

Resources for Schools

Related MCH Library Resources

Health Insurance and Access to Care for Children and Adolescents: Knowledge Path, 6th ed. (June 2010). (Updated: September 2011).
Author: Susan Brune Lorenzo, M.L.S., MCH Library.
Reviewers: Beth Dworetzky, M.S., Massachusetts Family Voices and Massachusetts Family-to-Family Health Information Center; Rochelle Mayer, Ed.D., National Center for Education in Maternal and Child Health; Margaret McManus, M.H.S., National Alliance to Advance Adolescent Health.
Editor: Ruth Barzel, M.A., MCH Library.

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