title: The Children's Health Insurance Program Reauthorization Act Evaluation Findings on Children's Health Insurance Coverage in an Evolving Health Care Landscape.
abstract: The Children's Health Insurance Program (CHIP) Reauthorization Act (CHIPRA) reauthorized CHIP through federal fiscal year 2019 and, together with provisions in the Affordable Care Act, federal funding for the program was extended through federal fiscal year 2015. Congressional action is required or federal funding for the program will end in September 2015. This supplement to Academic Pediatrics is intended to inform discussions about CHIP's future. Most of the new research presented comes from a large evaluation of CHIP mandated by Congress in the CHIPRA. Since CHIP started in 1997, millions of lower-income children have secured health insurance coverage and needed care, reducing the financial burdens and stress on their families. States made substantial progress in simplifying enrollment and retention. When implemented optimally, Express Lane Eligibility has the potential to help cover more of the millions of eligible children who remain uninsured. Children move frequently between Medicaid and CHIP, and many experienced a gap in coverage with this transition. CHIP enrollees had good access to care. For nearly every health care access, use, care, and cost measure examined, CHIP enrollees fared better than uninsured children. Access in CHIP was similar to private coverage for most measures, but financial burdens were substantially lower and access to weekend and nighttime care was not as good. The Affordable Care Act coverage options have the potential to reduce uninsured rates among children, but complex transition issues must first be resolved to ensure families have access to affordable coverage, leading many stakeholders to recommend funding for CHIP be continued.
authors.affiliation: Mathematica Policy Research, Ann Arbor, Mich. Electronic address: mharrington@mathematica-mpr.com.
authors.forename: Mary E
authors.initials: ME
authors.lastname: Harrington
mesh_terms: D000293:Adolescent; D039602:After-Hours Care; D002648:Child; D000067576:Child Health; D002662:Child Health Services; D002675:Child, Preschool; D065326:Children's Health Insurance Program / Q000191:economics / Q000331:legislation & jurisprudence*; D004608:Eligibility Determination; D005190:Family; D035082:Federal Government; D005260:Female; D005380:Financing, Government; D006297:Health Services Accessibility; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D008297:Male; D008484:Medicaid; D017057:Medically Uninsured; D010342:Patient Acceptance of Health Care; D058991:Patient Protection and Affordable Care Act / Q000191:economics / Q000331:legislation & jurisprudence*; D011203:Poverty; D015397:Program Evaluation; D012424:Rural Population; D014481:United States; D014505:Urban Population
keywords: Affordable Care Act; Children's Health Insurance Program; Children's Health Insurance Program Reauthorization Act; Medicaid; health care access; health care utilization; health insurance coverage