title: Coverage and care consequences for families in which children have mixed eligibility for public insurance.
abstract: Public health insurance for low-income children in the United States is primarily available through Medicaid and the Children's Health Insurance Program (CHIP). Mixed eligibility occurs when there is a mix of either "Medicaid- and CHIP-eligible" children or a mix of "eligible (for public insurance) and ineligible (for public insurance)" children in the family. We used data from the Medical Expenditure Panel Survey (MEPS) Household Component for 2001-12 to examine insurance coverage, access to care, and health care use for eligible children in families with mixed-eligible siblings compared to those in families where all siblings were eligible for one program. We found that mixed eligibility has a significant dampening effect for eligible children in families with a mix of eligible and ineligible siblings. These children were more likely to be uninsured and less likely to have a usual source of care, less likely to have any preventive dental or well-child visits during the year, and less likely to fully adhere to recommended preventive dental and well-child visits than eligible children with all-Medicaid- or all-CHIP-eligible siblings. We found no significant impact for eligible children living in Medicaid-CHIP-mixed families.
authors.affiliation: Julie L. Hudson (jhudson@ahrq.gov) is a senior economist in the Division of Modeling and Simulation, Center for Financing Access and Cost Trends, Agency for Healthcare Research and Quality, in Rockville, Maryland.
authors.forename: Julie L
authors.initials: JL
authors.lastname: Hudson
authors.affiliation: Salam Abdus is a senior economist at Social and Scientific Systems, in Rockville.
authors.forename: Salam
authors.initials: S
authors.lastname: Abdus
mesh_terms: D000293:Adolescent; D002140:California; D002648:Child; D002675:Child, Preschool; D004608:Eligibility Determination; D006297:Health Services Accessibility / Q000458:organization & administration*; D006801:Humans; D008962:Models, Theoretical; D012959:Socioeconomic Factors; D013221:State Health Plans / Q000458:organization & administration*; D014481:United States
keywords: Access To Care; CHIP; Children < Insurance; Children’s Health; Medicaid