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
- Agency
for Healthcare Research and Quality (AHRQ).
Evidence-based information on health care outcomes;
quality; and cost, use, and access. Resources
and initiatives include
Child
Health Care Quality Toolbox:
Measuring Quality in Children's
Health Programs. Tips
and tools to help state and
local policymakers and program
administrators evaluate Medicaid,
CHIP, Title V, and other
health programs for children
and adolescents.
CHIPRA Children's Health Care Quality Measurement and Improvement Activities. Outlines activities
and resources related to the quality provisions
of the Children's Health Insurance Program Reauthorization
Act (CHIPRA).
Child
Health Insurance Research Initiative (CHIRI™). Program
information and research
findings for policymakers to help them improve
access to, and the quality of, health care for children
and adolescents from families with low incomes.
- Alliance
for Health Reform: Child Health Insurance.
Webcasts, transcripts, and background materials
about child and adolescent health insurance
and access to care. The alliance is a nonpartisan,
nonprofit group aiming to inform policymakers,
journalists, and advocates about health coverage
issues.
- American
Academy of Pediatrics (AAP). Initiatives
and resources that address child and adolescent
health insurance and access to health care
include
2011
State Legislation Report.
(2012). This report outlines
state legislative activity
on 10 children's health
issues including Medicaid,
CHIP, and access to health
care.
Community Access
to Child Health (CATCH) Program. Grant information
and tools for this program to improve access to health
care by supporting pediatricians and communities
that are involved in community-based efforts for
children.
Healthy
Tomorrows Partnership for Children
Program (HTPCP). Information
about this grant program to
support community-based efforts
to improve access to health
care for families.
Pediatric Cost Model,
rev. ed. (2012). This is
an actuarial analysis of net
medical costs paid by insurers
for physician services for
children during 2008.
Also see AAP's resources about
health reform.
- Catalyst
Center: Improving Financing of Care for Children
and Youth with Special Health Care Needs.
Reports, issue briefs, data, and PowerPoint
presentations for policymakers, program administrators,
and health professionals about improving health
insurance and financing for children and adolescents
with special health care needs. Catalyst is
a national center located at the Boston University
School of Public Health and funded by the Maternal
and Child Health Bureau (MCHB). Resources include
Public Insurance Programs and Children with Special Health Care Needs: A Tutorial
on the Basics of Medicaid and
the Children's Health Insurance
Program (CHIP). (2012).
State-at-a-Glance
Chartbook on Coverage and Financing
for Children and Youth with Special
Health Care Needs. Data on selected
indicators of health coverage and
health care financing for children
and adolescents with special health
care needs in every state plus Washington,
DC and Puerto Rico.
Also see the Catalyst Center reports about
health reform.
- Census
Bureau. Data about health
insurance coverage in the United States.
Reports include
Income,
Poverty, and Health Insurance
Coverage in the United States:
2011. (2012).
[Report].
- Center
for Children and Families (CCF). Analyses
of federal policy developments and state-based
initiatives affecting the health insurance
coverage of America's families. CCF is an independent,
nonpartisan policy and research center based
at Georgetown University's Health Policy Institute.
Resources include
Medicaid and CHIP Programs. Information about the eligibility and enrollment and retention procedures of state Medicaid/CHIP programs for children, parents, and pregnant women.
Also see CCF's blog and Affordable Care Act resources.
- Center
on Budget and Policy Priorities (CBPP): Health.
Articles and analyses, podcasts, video, and
background information about health reform
and insurance coverage, including Medicaid
and CHIP. CBPP is a nonpartisan research and
policy organization that focuses on federal
and state fiscal policy and public programs
that affect families and individuals with low
or moderate incomes.
- Commonwealth
Fund. Reports, data, webinars, podcasts, newsletters,
and a blog on
topics that include child and adolescent health
and development, health insurance, state health
policy, and health reform.
The Commonwealth Fund is a private foundation
supporting independent research on health care
issues and making grants to improve health
care practice and policy.
- Families
USA. Background information, issue
briefs, fact sheets, charts, state news, advocacy
tools, a blog,
and newsletters and
about Medicaid, CHIP, CHIPRA, and health reform.
Families USA advocates at the national, state,
and community levels for high-quality, affordable
health care for all Americans. Resources
include
CHIPRA
Implementation Series: Exploring
New Opportunities for Children's
Coverage. [Issue brief
series].
Medicaid:
Making It Work for Consumers. Resources
for consumer-assistance programs, states,
and advocates to help consumers establish
their eligibility for Medicaid and
to get Medicaid to cover their health
care needs.
- Health
Resources and Services Administration/Maternal
and Child Health Bureau (MCHB).
EPSDT
and Title V Collaboration
to Improve Child Health.
Information about EPSDT and
about opportunities for collaboration
between Title V and Medicaid
to improve EPSDT services.
Presents strategies for improving
EPSDT administration and
performance. Resources address
systems of care issues, family
supports, data monitoring,
and evolving EPSDT policy.
State
MCH-Medicaid Coordination:
A Review of Title V and
Title XIX Interagency Agreements
(2nd ed). (2008). [Report].
Also see the Title
V Information System (TVIS),
the Discretionary
Grant Information System
(DGIS), and the MCH Library.
- Insure
Kids Now: For Professionals. Information,
policy guidance, and data about Medicaid and
CHIP. Includes CMS guidance on CHIPRA implementation
and information about and tools to support outreach
and enrollment efforts underway and funded
by CHIPRA.
- Kaiser
Family Foundation (KFF). An extensive
collection of resources about children's health
insurance coverage and care under Medicaid
and CHIP and health
reform. KaiserEDU.org offers
online tutorials and links to research, policy
analysis, and data for faculty and students
about Medicaid
and CHIP, the uninsured,
and health
reform. KFF is a nonprofit, private operating
foundation focusing on the major health care
issues facing the United States, as well as
the U.S. role in global health policy.
Also see statehealthfacts.org,
the Medicaid Benefits
Online Database, Kaiser Health
News, and resources about health
reform.
- Mathematica
Policy Research, Inc. Data and
analysis to inform decision making about health
insurance coverage for children, including Medicaid
and CHIP and national
health reform. Mathematica, a nonpartisan
research firm, conducts research and data collection
to improve public well-being. Publications
include
National
Evaluation of the State Children's Health Insurance
Program: A Decade of Expanding Coverage and Improving
Access. (2007). [Report].
Children's Health Insurance Program: An Evaluation (1997-2010). Interim Report
to Congress. (2011).
- Medicaid.gov. Information about Medicaid and CHIP, including federal policy guidance, lists of pending and approved waivers, highlights of Affordable Care Act implementation efforts, and state-specific program information and data. Presents an overview of
the EPSDT program, which provides comprehensive
health services for infants, children, and
adolescents enrolled in Medicaid.
- National
Academy for State Health Policy (NASHP).
State policy and program information and analyses,
research, and tools about health insurance
coverage and access to care and health reform.
NASHP is an independent academy of state health
policymakers working together to identify emerging
issues, develop policy solutions, and improve
state health policy and practice. Also see
NASHP's Maximizing Enrollment
for Kids program.
- National
Conference of State Legislatures (NCSL): Health.
Background information, federal and state legislative
news and bill summaries, issue briefs, reports,
and multimedia resources for state policymakers
about health insurance, access to health care,
Medicaid and CHIP, and health reform. NCSL,
an association of state lawmakers and legislative
staff members, conducts research and offers
technical assistance on state issues, including
health policy.
- National
Health Law Program (NHeLP). Fact sheets,
issue briefs, case dockets, and legal transmittals
about Medicaid and CHIP. NHeLP is a national
public-interest law firm that aims to improve
health care for families with low incomes,
minorities, the elderly, and people with disabilities.
- National
Health Policy Forum. Issue briefs,
papers, and glossaries about health insurance
and the uninsured, Medicaid and CHIP, and health
reform. NHPF is based at the George Washington
University and offers educational programming
designed to help congressional and federal
agency staff become better informed about current
health policy issues
- Urban
Institute (UI): Health Policy Center.
Research and analysis about issues affecting
child and adolescent health insurance, access
to care, and health reform. UI is a nonpartisan
economic and social policy research organization.
Additional
Electronic Publications
- Allen K. 2008. Medicaid
Managed Care for Children in Child Welfare.
Hamilton, NJ: Center
for Health Care Strategies, Inc. [Issue
brief].
- Bureau
of Primary Health Care (BPHC). 2008. Health
Centers: America's Primary Care Safety Net, Reflections
on Success, 2002–2007. Rockville, MD: Health
Resources and Services Administration (HRSA).
[Report].
- Chandra A, Gresenz CR, Blanchard
JC, Cuellar AE, Ruder T, Chen AY, Gillen EM. 2009. Health
and Health Care Among District of Columbia Youth.
Santa Monica, CA: RAND
Corporation. [Report, Executive
summary, Research
brief].
- Chay KY, Guryan J, Mazumder B.
2009. Birth
Cohort and the Black-White Achievement Gap: The
Roles of Access and Health Soon After Birth.
Cambridge, MA: National
Bureau of Economic Research. [Paper].
- Effros R. 2010. Analysis
of Medicaid/SCHIP Eligibility. Santa Monica,
CA: RAND Corporation.
[Report].
- Government
Accountability Office (GAO). 2010. Medicaid
and CHIP: Enrollment, Benefits, Expenditures,
and Other Characteristics of State Premium Assistance
Programs. Washington, DC: Government Accountability
Office. [Report].
- Government
Accountability Office (GAO). 2009. Medicaid
Preventive Services: Concerted Efforts Needed
to Ensure Beneficiaries Receive Services.
Washington, DC: Government Accountability Office.
[Report].
- Government
Accountability Office (GAO). 2009. State
Children's Health Insurance Program: CMS Should
Improve Efforts to Assess Whether SCHIP Is Substituting
for Private Insurance. Washington, DC: Government
Accountability Office. [Report].
- Guttmacher
Institute. 2010. Minors'
Access to Prenatal Care. New York, NY: Guttmacher
Institute. [Fact sheet]. Also see the fact sheets, Minors'
Access to Contraceptive Services (2010) and Minors'
Access to STI Services (2010).
- Institute
of Medicine (IOM). 2009. America's
Uninsured Crisis: Consequences for Health and
Health Care. Washington, DC: National
Academies Press. [Report].
- King J, Slifkin R, Homes M. 2009. Characteristics
of Rural and Urban Children Who Qualify for Medicaid
or CHIP but Are Not Enrolled. Chapel Hill,
NC: North
Carolina Rural Health Research and Policy Analysis
Center. [Issue brief]. Also see the companion
brief, Medicaid
and CHIP Participation Among Rural and Urban
Children (2009).
- Lawrence RS, Gootman JA, Sim LJ,
eds. 2009. Adolescent
Health Services: Missing Opportunities. Washington,
DC: National Academies
Press. [Report].
- Levine PB, Schanzenbach DW. 2009. The
Impact of Children's Public Health Insurance
Expansions on Educational Outcomes. Cambridge,
MA: National Bureau
of Economic Research (NBER). [Paper].
- Levine PB, McKnight R, Heep S.
2009. Public
Policy, Health Insurance and the Transition to
Adulthood. Cambridge, MA: National
Bureau of Economic Research (NBER). [Paper].
- Napel ST, Bulchis
A, Friedenzohn I, McGlynn C. 2010. State
of the States 2010: The State We're In. Washington,
DC: AcademyHealth.
[Annual report].
- National Adolescent and Young Adult Health Information Center (NAHIC).
2008. Fact
Sheet on Health Care Access and Utilization:
Adolescents and Young Adults. San Francisco,
CA: University of California, San Francisco.
[Fact sheet].
- National Advisory Committee on Rural Health and Human Services. 2009. The
2009 Report to the Secretary: Rural Health and
Human Service Issues. Washington, DC: National
Advisory Committee on Rural Health and Human
Services. [Report].
- Office
of the Inspector General. 2010. Most
Medicaid Children in Nine States Are Not Receiving
All Required Preventive Screening Services.
Washington, DC: Department
of Health and Human Services (DHHS). [Report].
- Perry M. 2009. Reducing
Enrollee Churning in Medicaid, Child Health Plus,
and Family Health Plus: Findings from Eight Focus
Groups with Recently Disenrolled Individuals.
New York, NY: NYS
Health Foundation. [Report].
- Reagin A. 2009. Strengthening
Health Care for Children: Primary Care and the
Medical Home. Washington, DC: National
Business Group on Health. [Issue brief].
- Southern
Institute on Children and Families. 2009. Medicaid
and CHIP Retention: A Key Strategy to Reducing
the Uninsured. Columbia, SC: Southern Institute
on Children and Families. [Report].
- Stebbins H. 2009. Making
Maternal and Child Health a Priority. New
York, NY: National
Center for Children in Poverty. [Fact
sheet].
Databases
See the following set of MCH Library resource briefs to identify additional data and statistics, literature and research, and programs about health insurance
and access to health care for children and adolescents.
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.
- American
Academy of Pediatrics (AAP): Federal Implementation of the Affordable Care Act.
Fact sheets, press releases, and testimony
about implementing the health reform law to
provide the best possible outcomes for children
and the pediatricians who care for them.
- Association
of Maternal and Child Health Programs (AMCHP):
National Center for Health Reform Implementation. Summary
of MCH-related provisions in the federal health
reform bills and links to health reform implementation
timelines, summaries, and fact sheets.
- Catalyst
Center: Improving Financing of Care for Children
and Youth with Special Health Care Needs.
Health
Care Reform and Children and
Youth with Special Health Care
Needs: Coverage Is Not Enough.
(2009). [Issue brief].
What
Do Children with Special Health
Care Needs Require from Health Care
Reform? (2009). [Issue brief].
- Center
for Children and Families (CCF): Affordable Care Act. Fact sheets, issue briefs,
a blog, and other health
reform implementation resources for states.
Resources include
Summary
of Medicaid, CHIP, and Low-Income Provisions
in Health Care Reform. (March 2010).
[Fact sheet].
- Childrens
Defense Fund (CDF): Health Reform Implementation. Information about what the legislation means for children and young adults and an implementation timeline that shows when important provisions for children and families will go into effect. Includes information about children's health coverage in each state including data on the uninsured,
those enrolled in Medicaid and CHIP, income
eligibility, and enrollment procedures.
- Commonwealth
Fund: Health Reform Resources. Reports,
charts, webinars, podcasts, a newsletter,
and a blog on
health reform topics that include health system
reform, expanding access, payment reform, and
quality improvement efforts. See the Health Reform Resource Center to view a timeline of the Affordable Care Act's major provisions and use the
Find Health Reform Provisions tool to search
for summaries of specific provisions by year,
category, and/or stakeholder group. Also link
to the full-text
of the Patient Protection and Affordable Care
Act and the Health Care and Education Affordability
Reconciliation Act of 2010.
- First
Focus: Making Children and Families the Priority.
Reports, public opinion research, and advocacy
tools about protecting the needs of children
in national health reform. First Focus is a
bipartisan advocacy organization that is committed
to making children and families a priority
in federal policy and budget decisions. Also
see ChildrensBudget.org.
- Kaiser
Family Foundation (KFF): Health Reform Source.
Issue briefs and in-depth analysis, data, testimony,
public opinion polls, news headlines, and multimedia
tools about health reform. Includes fact sheets,
reports, and interactive maps that describe
state health reform initiatives. Also see Kaiser
Health News and the KaiserEDU.org collection
of online tutorials and resources for faculty
and students about health
reform.
- State Coverage Initiatives (SCI): Coverage By State. Information about state health coverage programs and coverage strategies.
- Fox HB, McManus MA. 2009. Health
Reform and Adolescents. Washington, DC: National
Alliance to Advance Adolescent Health. [Issue brief].
- Also see the Alliance
for Health Reform and its issue brief, Future
of Children's Health Coverage (2010).
Outreach
and Enrollment
- Children's
Partnership: E-Enrollment and Express Lane
Eligibility. Information for and
about state Medicaid and CHIP programs that
streamline enrollment and automate renewal.
Includes an implementation toolkit, reports,
presentations, fact sheets, forms and other
administrative documents, and a newsletter.
- Insure
Kids Now: Connecting Kids to Coverage Support.
Information about grants for outreach, enrollment,
and retention; webinars about outreach; and
an outreach toolkit.
- National
Academy for State Health Policy (NASHP): Maximizing
Enrollment. Information about
this program to increase enrollment and retention
of eligible children into Medicaid and CHIP
programs and to establish and promote best
practices among states.
- Brellochs C, King KF, Vanneman
M, Lief A, Fryer GF, Aguayo S, Cadogan M, Platt
R, Barbot O. 2009. The
Access to Coverage and Care Project: An Analysis
of Health Insurance Enrollment and Retention and
Students in Selected NYC Public Schools. New
York, NY: New
York City Human Resources Administration. [Report].
- Idala D, Roddy T, Milligan C, Sommers
A, Boddie-Willis C, Clark A, Dorn S. 2009. Using
Information from Income Tax Forms to Target Medicaid
and CHIP Outreach: Preliminary Results of the Maryland
Kids First Act. Minneapolis, MN: State Health
Access Data Assistance Center (SHADAC). [Issue brief, Webinar].
- Rosenbaum S. 2008. Medicaid
Portability in the Context of Oral Health Care
for Head Start–Enrolled Children in Migrant
Farmworker Families. Washington, DC: School
of Public Health and Health Services, George
Washington University. [Analysis].
- Santoro K, Murphy B, Pirani H.
2009. Increasing
Access to Health Insurance for Children and Families:
Innovative Health Plan Outreach and Enrollment
Efforts. Washington, DC: National Institute
for Health Care Management Research and Educational
Foundation. [Issue brief].
- Also see the AcademyHealth report, State
of the States 2010: The State We're In (2010),
and the MCH Library bibliography, Outreach
Programs and Strategies.
Resources for Families
Resources for Schools
Related MCH Library Resources
- Children and Youth with Special Health Care Needs knowledge path, family resource brief, school resource brief
- Community Services Locator: An Online Directory for Finding Community Services for Children and Families knowledge path
- Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid knowledge path, family resource brief
- Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents knowledge path, family resource brief, school resource brief
- Racial and Ethnic Disparities in Health knowledge path, family resource brief
Health Insurance and Access to Care for Children and
Adolescents: Knowledge Path, 6th ed. (June 2010). (Updated: January 2013).
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.
