Parental enrollment in SCHIP: Is there adverse health selection among parents who enroll?

ABSTRACT (218 Words) Objective: Beginning in October 2000, New Jersey's State Children's Health Insurance Program (SCHIP) extended eligibility to parents in families up to 200% of the Federal Poverty Level (FPL) without other insurance. We study whether SCHIP eligible parents who are in poor health are more likely to enroll.

Methods: Data are from the 2003 NJ FamilyCare (NJFC) Family Health Survey. Children were randomly selected from the universe of children enrolled in NJFC as of May 2002, and their families surveyed during summer 2003 to determine current health coverage status. Health measures include self-rated health, chronic health condition indicators, symptoms index, and a special health care needs screener. Logistic regression models will be estimated to assess whether poor health is associated with eligible parents enrolling in SCHIP, controlling for demographic, occupational, and employment characteristics.

Results: Of parents within the income eligibility threshold (N=649), 46% are eligible to enroll in SCHIP; of those, 61% enroll. Among parents of SCHIP children, parents who were themselves enrolled had the highest prevalence of chronic health conditions.

Conclusions: Increasing take-up among low-income families eligible for SCHIP can help many states newly interested in requiring universal coverage attain that goal. Examining which parents enroll and whether there is adverse selection of less healthy parents can assist in identifying potential fiscal and enrollment challenges.