Is There Adverse Retention of Children with Special Health Care Needs in SCHIP?

Objective. To determine whether children with special health care needs (CSHCN) are more likely to remain in New Jersey's State Children's Health Insurance Program (SCHIP) and less likely to become uninsured than non-CSHCN. Patients and Methods. We used the 2003 NJ FamilyCare (NJFC) Supplement to the New Jersey Family Health Survey. Children were randomly selected from those enrolled in NJFC as of May 2002 (N=675), and their families surveyed during summer 2003. The CSHCN Screener (Child and Adolescent Health Measurement Initiative) was used to identify five types of special health care needs (SHCN). To assess whether adverse retention into SCHIP was occurring, we estimated multinomial logistic regression models of final enrollment status according to the presence of one or more SHCN, controlling for demographic characteristics. Results. Roughly one out of every five children in NJ FamilyCare had at least one SHCN. Older children and boys had greater odds of having SHCN than others. CSHCN had only one-quarter the odds of becoming disenrolled and uninsured, compared to children without SHCN, even when controlling for age, sex, race/ethnicity, and SCHIP plan level. There was no difference in likelihood of finding other health insurance according to CSHCN status. Conclusions. Children with special health care needs were more likely than children without such needs to be covered by health insurance at the time of the survey – either by retaining SCHIP coverage or having found other insurance. Higher health care costs for these children should be considered in federal and state budget planning for SCHIP.