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

Abstract #120560

Dana C. Hughes, DrPH¹, Embry Howell, MSPH, PhD², Genevieve Kenney, PhD³, Jennifer Sullivan³, and Martha Kovac⁴. (1) Institute for Health Policy Studies; Department of Family and Community Medicine, University of California, San Francisco, 3333 California St., Suite 265, San Francisco, CA 94143, 415-476-0780, dhughes@itsa.ucsf.edu, (2) Health Policy Center, The Urban Institute, 2100 M St., N.W., Washington, DC 20037, (3) Health Policy Center, Urban Institute, 2100 M Street, NW, Washington, DC 20037, (4) Mathematica Policy Research Inc, PO Box 2393, Princeton, NJ 08543-2393

The five year evaluation of San Mateo's initiative to cover all children below 400% of poverty began in May, 2003. Two rounds of site visits to study implementation; detailed data on services and cost from the Health Plan of San Mateo where most children are enrolled; focus groups with parents of enrolled children; a telephone survey of 400 parents of enrolled children; interviews with providers; and hospital cost and utilization for uninsured and insured children.

The San Mateo County CHI developed from an intensive collaboration between both public and private partners, including the county's Health and Human Services Agencies. County-wide outreach, targeted to the pockets of low income areas in an affluent county, succeeded an enrolling a large number of children rapidly. Due to an improving economy and a larger-than-expected attrition at re-enrollment, enrollment has leveled off at about 5500 children. Parents report high satisfaction with the program. Access to care, when measured in terms of the percent of children with a usual source of care or unmet need, is relatively high with 88% of parents reporting their child has a usual source of care. Crowd-out does not appear to be high, even among the small number of higher income (250-400% of poverty) children. County hospitals have experienced a decline in the admissions of uninsured children. Some early indicators suggest that the program has had a positive affect on low income children and families, as well as the providers serving them.

Learning Objectives:

• To describe the implementation and impact of increasing health insurance coverage for children, including undocumented children and children between 250 and 400% of the federal poverty level

Keywords: Access and Services,

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