Historical Overview of Children's Health Care Coverage

Mann, Cindy; Rowland, Diane; Garfield, Rachel

doi:10.2307/1602638

Cited by 32 publications

(23 citation statements)

References 5 publications

(2 reference statements)

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“…21 By providing comprehensive health insurance, SCHIP was intended to improve the health care for low-income, uninsured children. 22 Title XXI of the Social Security Act provided states with substantial flexibility in designing or modifying their SCHIP programs. 23,24 Unlike Medicaid, SCHIP…”

mentioning

confidence: 99%

Improved Access and Quality of Care After Enrollment in the New York State Children's Health Insurance Program (SCHIP)

et al. 2004

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ABSTRACT. Background. Although many studies have noted that uninsured children have poorer access and quality of health care than do insured children, few studies have been able to demonstrate the direct benefits of providing health insurance to previously uninsured children. The State Children's Health Insurance Program (SCHIP), enacted as Title XXI of the Social Security Act, was intended to improve insurance coverage and access to health care for low-income, uninsured children. With limited state and federal resources for health care, continued funding of SCHIP requires demonstration of success of the program. As yet, little is known about the effectiveness of SCHIP on improving access and quality of care to enrollees.Objectives. To measure the impact of the New York State (NYS) SCHIP on access, utilization, and quality of health services for enrolled children.Design Setting. NYS, stratified into 4 regions. The NYS SCHIP is modeled on commercial insurance (32 managed care plans) and at the time of the study had 18% of SCHIP enrollees nationwide.Study Design. For the study group, the design used pre/poststudy telephone interviews of parents of children enrolling in the NYS SCHIP, with baseline interviews soon after enrollment and follow-up interviews 1 year after enrollment. Baseline interviews reflected the child's experience during the 1-year period before enrollment in SCHIP. The follow-up interviews reflected the 1-year period after enrollment in SCHIP. For the comparison group, the design used baseline interviews of a comparison group enrolled 1 year after the study group to test for secular trends; these interviews reflected the 1-year period before enrollment in SCHIP.Subjects. Children (n ‫؍‬ 2644) 0 to 18 years of age who enrolled in the NYS SCHIP for the first time (November 2000 to March 2001), stratified by age (0-5, 6-11, and 12-18 years), race/ethnicity (white non-Hispanic, black nonHispanic, and Hispanic; others excluded), and region of NYS. The comparison group consisted of 400 children. Telephone interviews were conducted in English or Spanish throughout the day and evening, 7 days per week, to obtain measures.Main Outcome Measures. Demographic and health measures (child and family characteristics, health status, presence of a special health care need, and prior health insurance), access (usual source of care [USC] and unmet needs for health care), utilization (visits for specific health services), and quality (continuity with USC and measures of primary care interactions). Analyses included bivariate tests, comparing the pre-SCHIP period to the 1-year period after enrollment in SCHIP. Multivariate models were computed to generate standardized populations comprised of key characteristics of the sample to test for differences in measures (after SCHIP versus before SCHIP), controlling for demographic characteristics.Results. Of the 2644 study-group children who completed the initial interview, 2290 (87%) completed the follow-up interview. Key measures for the pre-SCHIP period and short-term "pos...

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confidence: 99%

Improved Access and Quality of Care After Enrollment in the New York State Children's Health Insurance Program (SCHIP)

et al. 2004

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“…In process at the time, though, was the phase-in of Medicaid coverage for children ages 6 to 18 in families with incomes at or below the federal poverty level. Coverage was phased in by covering older age levels every year until all were covered to age 18 by 2002 (Mann, Rowland, & Garfield, 2003). Data from 2013 indicate that 27% of children in South Carolina under age 18 live in poverty and 51% live in low-income households (National Center for Children in Poverty, 2014); and 32% of children of immigrant parents live in poor families (National Center for Children in Poverty, 2016).…”

Section: Healthy Learners a Community Health-school Health Partnershipmentioning

confidence: 99%

School Nurses

Duff

Poole²

2016

NASN School Nurse

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School nurses coordinate student health care for prevention and treatment to remove health barriers to learning and to school attendance. They use a team approach to manage students with chronic conditions as they transition among home, school and healthcare settings, working to develop competent self-care aligned with developmental ages of students. Care coordination ensures the continuum of care is unbroken. Meeting the health needs of low-income students can be challenging, because those students are likely to be uninsured or underinsured and often lack necessary resources, such as transportation, to access primary health care. Care coordination is a tenet of school nursing and to optimally serve low-income students, school nurses form partnerships in the community. One innovative and successful partnership is Healthy Learners, an organization that works with community healthcare providers and school district nurses to connect eligible students to needed healthcare services. Always, the goal is to keep students in school, healthy, and ready to learn.

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“…Among poor children, a decline in coverage was experienced between 1994 and 2000, whereas near-poor children experienced an increase in coverage during this time period. The emergence of the State Children's Health Insurance Program (S-CHIP) explains some of this increase (Mann, Rowland, & Garfield, 2003;Wolfe, Haveman, Kaplan, & Cho, 2004), although eligible families do not always apply for such coverage. State variation in S-CHIP characteristics (e.g., the availability of assistance with applications, premium charges, whether Medicaid remains a distinct program) has been linked to take-up rates (Wolfe & Scrivner, 2005).…”

Section: Health Care Accessmentioning

confidence: 99%

Welfare, work, and health care access predictors of low-income children's physical health outcomes

Slack

Holl

Yoo

et al. 2007

Children and Youth Services Review

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This analysis examines whether young children's (N= 494) general physical health is associated with parental employment, welfare receipt, and health care access within a low-income population transitioning from welfare to work. A latent physical health measure derived from survey and medical chart data is used to capture children's poor health, and parental ratings of child health are used to identify excellent health. Controlling for a host of factors associated with children's health outcomes, results show that children of caregivers who are unemployed and off welfare have better health than children of caregivers who are working and off welfare. Children whose caregivers are unemployed and on welfare, or combining work and welfare, have health outcomes similar to children of caregivers who are working and off welfare. Health care access characteristics, such as gaps in health insurance coverage, source of primary care setting, and type of health insurance are associated with children's general physical health. Implications of these results for state TANF programs are discussed.Children in low-income families are more likely to be reported by their caregivers as having poor health and have been shown to have higher rates of mortality, disability, and cooccurring health conditions than children from higher-income families (Starfield, 1997;

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Historical Overview of Children's Health Care Coverage

Cited by 32 publications

References 5 publications

Improved Access and Quality of Care After Enrollment in the New York State Children's Health Insurance Program (SCHIP)

Improved Access and Quality of Care After Enrollment in the New York State Children's Health Insurance Program (SCHIP)

School Nurses

Welfare, work, and health care access predictors of low-income children's physical health outcomes

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