Determinants of children's participation in California's Medicaid and SCHIP programs.
OBJECTIVE
To develop a comprehensive predictive model of eligible children's enrollment in California's Medicaid (Medi-Cal [MC]) and State Children's Health Insurance Program (SCHIP; Healthy Families [HF]) programs.


METHODS
2001 California Health Interview Survey data, data on outstationed eligibility workers (OEWs), and administrative data from state agencies and local health insurance expansion programs for fiscal year 2000-2001.


METHODS
The study examined the effects of multiple family-level factors and contextual county-level factors on children's enrollment in Medicaid and SCHIP.


METHODS
Simple logistical regression analyses were conducted with sampling weights. Hierarchical logistic regressions were run to control for clustering.


RESULTS
Participation in MC and HF programs is determined by a combination of family-level predisposing, perceived need, and enabling/disabling factors, and county-level enabling/disabling factors. The strongest predictors of MC enrollment were family-level immigration status, ethnicity, and income, and the presence of a county-level "expansion program"; and the county-level ratio of OEWs to eligible children. Important HF enrollment predictors included family-level ethnicity, age, number of hours a parent worked, and urban residence; and county-level population size and outreach and media expenditure.


CONCLUSIONS
MC and HF outreach/enrollment efforts should target poorer and immigrant families (especially Latinos), older children, and children living in larger and urban counties. To reach uninsured eligible children, it is important to further simplify the application process and fund selected outreach efforts. Local health insurance expansion programs increase children's enrollment in MC.
Kincheloe
Jennifer
J
UCLA Center for Health Policy Research, 10960 Wilshire Blvd, Suite 1550, Los Angeles, CA 90024, USA.
Frates
Janice
J
Brown
E Richard
ER
D000293:Adolescent; D002648:Child; D002662:Child Health Services / Q000458:organization & administration / Q000706:statistics & numerical data*; D002675:Child, Preschool; D004641:Emigration and Immigration; D005006:Ethnicity; D005190:Family; D006297:Health Services Accessibility; D006304:Health Status; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D007802:Language; D008484:Medicaid / Q000458:organization & administration / Q000706:statistics & numerical data; D008483:Medical Assistance / Q000458:organization & administration / Q000706:statistics & numerical data*; D013221:State Health Plans / Q000458:organization & administration / Q000706:statistics & numerical data*; D014481:United States