title: Discontinuity of coverage for Medicaid and S-CHIP children at a transitional birthday.
abstract: OBJECTIVE
  To investigate disenrollment from public insurance at the 6-year transitional birthday when eligibility for many children moves from Medicaid to State Children's Health Insurance Program (S-CHIP).
  
  
  METHODS
  Data from Georgia's S-CHIP (PeachCare) and Medicaid programs from 2000 to 2002.
  
  
  METHODS
  The likelihood of dropping public coverage after the reference birthday is modeled for children turning age 6 compared with a control cohort of children turning age 9 controlling for demographic and geographic differences between enrollees.
  
  
  RESULTS
  Over 17 percent of 6-year-olds versus only 7 percent of the control cohort dropped coverage. After controlling for other factors (e.g., race/ethnicity, prior enrollment, and geographic region) having lower historical expenditures is predictive of dropping coverage among all children, although the unadjusted effect is stronger among children enrolled in PeachCare before their sixth birthday. Only 1 percent of Medicaid children who remained covered transitioned to PeachCare.
  
  
  CONCLUSIONS
  Turnover at transitional birthdays identifies a common pathway for children into the ranks of the uninsured. Facilitating continuous enrollment would retain in the programs children with lower than average expenditures. This may be one of the more cost effective ways of reducing the number of uninsured children in Georgia.
authors.affiliation: Institute of Health Administration, Robinson College of Business, Georgia State University, Atlanta, GA 30302-3988, USA.
authors.forename: Patricia
authors.initials: P
authors.lastname: Ketsche
authors.forename: E Kathleen
authors.initials: EK
authors.lastname: Adams
authors.forename: Angela
authors.initials: A
authors.lastname: Snyder
authors.forename: Mei
authors.initials: M
authors.lastname: Zhou
authors.forename: Karen
authors.initials: K
authors.lastname: Minyard
authors.forename: Rebecca
authors.initials: R
authors.lastname: Kellenberg
mesh_terms: D002648:Child; D002662:Child Health Services / Q000458:organization & administration* / Q000706:statistics & numerical data; D004608:Eligibility Determination; D005006:Ethnicity; D005845:Georgia; D005102:Health Expenditures / Q000706:statistics & numerical data; D006801:Humans; D019458:Insurance Coverage / Q000458:organization & administration* / Q000706:statistics & numerical data; D007348:Insurance, Health; D008484:Medicaid / Q000458:organization & administration* / Q000706:statistics & numerical data; D044469:Racial Groups; D012111:Residence Characteristics / Q000706:statistics & numerical data; D013221:State Health Plans / Q000458:organization & administration* / Q000706:statistics & numerical data; D014481:United States