Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #110254

Shana A. Lavarreda, MPP¹, E. Richard Brown, PhD², Thomas Rice, PhD³, Melissa Gatchell⁴, and Jennifer Kincheloe, MPH². (1) Center for Health Policy Research, University of California, Los Angeles, 10911 Weyburn Ave., Suite 300, Los Angeles, CA 90024, (2) UCLA Center for Health Policy Research, 10911 Weyburn Ave, Suite 300, Los Angeles, CA 90024, 310 794-0812, erbrown@ucla.edu, (3) Department of Health Services, UCLA School of Public Health, P.O.Box 951772, Los Angeles, CA 90095-1772, (4) Center for Health Policy Research, UCLA School of Public Health, 10911 Weyburn Ave., Suite 300, Los Angeles, CA 90024

We examine the rates of enrollment change, or churning, in California's Medicaid and SCHIP programs (Medi-Cal and Healthy Families) using new data from the 2003 and 2001 California Health Interview Surveys. First we assess the extent of change between 2001 and 2003 for the following groups: children (ages 0-18) enrolled in Medi-Cal and Healthy Families after being previously uninsured, children who became uninsured after losing Medi-Cal and Healthy Families coverage, and children who had continuous Medi-Cal and Healthy Families over the entire year. We also perform multivariate analysis, with increased enrollment and retention of Medi-Cal and Healthy Families enrollees as the dependent variables. Independent variables will include existence of a county-level public insurance program, sociodemographic indicators and employment-related factors. Preliminary findings indicate that the proportion of children in California continuously enrolled in Medi-Cal and Healthy Families over the course of a year substantially and significantly increased from 2001 to 2003, with over half a million children gaining continuous coverage. Our findings assess the impact that outreach efforts had on this gain, as opposed to the administrative change. It is anticipated that the number of uninsured children who received coverage will have significantly increased from 2001 to 2003, and that the number of children who lost their public coverage and became uninsured will have decreased. We hypothesize that local county efforts had a measurable impact on successful enrollment and that policy changes that increased the duration of eligibility for children in Medi-Cal enabled more children to keep their coverage, once obtained. Our analysis will demonstrate the effectiveness in local outreach and retention efforts in California between 2001 and 2003. With state budgets across the country facing shortfalls in their Medicaid and SCHIP budgets, it becomes vital to carefully assess the effectiveness of previous enrollment efforts for these increasingly costly programs. Between 2001 and 2003, employer-based coverage sharply declined for children and adults, but California offset that decline for children with expanded enrollment in Medi-Cal and Healthy Families. In fact, the overall uninsured rate for California's children declined during this time period, despite economic recession and state budget deficits, due entirely to expanded public coverage. This success may serve as a case study for other states.

Learning Objectives:

• 1) Identify factors having the greatest impact on increased enrollment and retention of Medicaid and SCHIP enrollees in California.
• 2) Discuss population churning in Medicaid and SCHIP.

Keywords: Insurance,

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.

Recorded presentation