Expanding public health insurance to parents: effects on children's coverage under Medicaid. 2003

Lisa Dubay, and Genevieve Kenney
The Urban Institute, Washington, DC 20037, USA.

OBJECTIVE To assess whether expanding public health insurance coverage to parents leads to increases in Medicaid participation among children. METHODS Study uses data from the 1997 and 1999 National Survey of America's Families. Insurance coverage of children eligible for Medicaid under the poverty-related expansions is analyzed. METHODS We conduct two analyses. In the first, we examine the cross-sectional difference regarding whether Medicaid participation is higher for children eligible for Medicaid under the poverty-related expansions when states expand public health insurance programs to cover their parents. In the second, we use a difference-in-difference approach to assess whether the expansion of the Medicaid program to cover parents in Massachusetts led to an increase in Medicaid coverage among children between 1997 and 1999 relative to changes that occurred in the rest of the nation. METHODS The analysis relies on a detailed Medicaid and SCHIP eligibility simulation model that identifies children surveyed on the NSAF who are eligible for Medicaid under the poverty-related expansions. RESULTS Children who reside in states that expanded public health insurance programs to parents participate in Medicaid at a rate that is 20 percentage points higher than of those who live in states with no expansions. The Massachusetts expansion in coverage to parents led to a 14 percentage point increase in Medicaid coverage among children due principally to reductions in uninsurance among already eligible children. CONCLUSIONS Expanding public health insurance coverage to parents has benefits to children in the form of increased participation in Medicaid.

UI MeSH Term Description Entries
D007342 Insurance Benefits Payments or services provided under stated circumstances under the terms of an insurance policy. In prepayment programs, benefits are the services the programs will provide at defined locations and to the extent needed. Health Benefits,Insurance Beneficiary,Beneficiaries, Insurance,Beneficiary, Insurance,Benefit, Health,Benefit, Insurance,Benefits, Health,Benefits, Insurance,Health Benefit,Insurance Beneficiaries,Insurance Benefit
D008404 Massachusetts State bounded on the north by New Hampshire and Vermont, on the east by the Atlantic Ocean, on the south by Connecticut and Rhode Island, and on the west by New York.
D008484 Medicaid Federal program, created by Public Law 89-97, Title XIX, a 1965 amendment to the Social Security Act, administered by the states, that provides health care benefits to indigent and medically indigent persons. Dental Medicaid Program,Medical Assistance, Title 19,Dental Medicaid Programs,Medicaid Program, Dental,Medicaid Programs, Dental,Program, Dental Medicaid,Programs, Dental Medicaid
D010290 Parents Persons functioning as natural, adoptive, or substitute parents. The heading includes the concept of parenthood as well as preparation for becoming a parent. Step-Parents,Parental Age,Parenthood Status,Stepparent,Age, Parental,Ages, Parental,Parent,Parental Ages,Status, Parenthood,Step Parents,Step-Parent,Stepparents
D011203 Poverty A situation in which the level of living of an individual, family, or group is below the standard of the community. It is often related to a specific income level. Federal Poverty Level,Federal Poverty Threshold,Indigency,Low-Income Population,Absolute Poverty,Extreme Poverty,Indigents,Low Income Population,Federal Poverty Levels,Indigent,Level, Federal Poverty,Low Income Populations,Low-Income Populations,Population, Low Income,Population, Low-Income,Poverty Level, Federal,Poverty Threshold, Federal,Poverty, Absolute,Poverty, Extreme
D012044 Regression Analysis Procedures for finding the mathematical function which best describes the relationship between a dependent variable and one or more independent variables. In linear regression (see LINEAR MODELS) the relationship is constrained to be a straight line and LEAST-SQUARES ANALYSIS is used to determine the best fit. In logistic regression (see LOGISTIC MODELS) the dependent variable is qualitative rather than continuously variable and LIKELIHOOD FUNCTIONS are used to find the best relationship. In multiple regression, the dependent variable is considered to depend on more than a single independent variable. Regression Diagnostics,Statistical Regression,Analysis, Regression,Analyses, Regression,Diagnostics, Regression,Regression Analyses,Regression, Statistical,Regressions, Statistical,Statistical Regressions
D002648 Child A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL. Children
D002662 Child Health Services Organized services to provide health care for children. Infant Health Services,Child Services, Health,Health Services, Child,Health Services, Infant,Infant Services, Health,Services, Child Health,Services, Infant Health,Child Health Service,Health Service, Child,Health Service, Infant,Infant Health Service,Service, Child Health,Service, Infant Health
D003430 Cross-Sectional Studies Studies in which the presence or absence of disease or other health-related variables are determined in each member of the study population or in a representative sample at one particular time. This contrasts with LONGITUDINAL STUDIES which are followed over a period of time. Disease Frequency Surveys,Prevalence Studies,Analysis, Cross-Sectional,Cross Sectional Analysis,Cross-Sectional Survey,Surveys, Disease Frequency,Analyses, Cross Sectional,Analyses, Cross-Sectional,Analysis, Cross Sectional,Cross Sectional Analyses,Cross Sectional Studies,Cross Sectional Survey,Cross-Sectional Analyses,Cross-Sectional Analysis,Cross-Sectional Study,Cross-Sectional Surveys,Disease Frequency Survey,Prevalence Study,Studies, Cross-Sectional,Studies, Prevalence,Study, Cross-Sectional,Study, Prevalence,Survey, Cross-Sectional,Survey, Disease Frequency,Surveys, Cross-Sectional
D004608 Eligibility Determination Criteria to determine eligibility of patients for medical care programs and services. Eligibility Certification,Certification, Eligibility,Certifications, Eligibility,Determination, Eligibility,Determinations, Eligibility,Eligibility Certifications,Eligibility Determinations

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