The impact of the State Children's Health Insurance Program on children's access to care and use of health care services

This study examines the role of recent public health insurance expansions, particularly the State Children's Health Insurance Program (SCHIP), in improving access to health care and use of health care services for children living in low-income families using the National Health Interview Survey (NHIS). The first study examines the impact of SCHIP on access and use in a before and after analysis using 1997 as a baseline and 2003 as the endpoint. The results indicate that SCHIP has led to substantial gains in insurance coverage for children living in families with incomes between 100% and 199% of the FPL---the target income group for SCHIP. Although some of the gains in public coverage were offset by losses in private coverage, the proportion of children in the target income group who were uninsured for the full year declined by nearly half between 1997 and 2003. There was also a significant reduction in the proportion of children without a provider visit in the past year. Other measures included in the study such as receipt of preventive well child visits showed no significant changes over the study period.;The second study focuses on oral health in children and examines the impact of recent public insurance expansions on the use of dental care in children from 2 to 17 years of age. A trend analysis was conducted using seven years of data from the NHIS---1983 as the baseline and 2001-02 as the endpoint---with two intermediate data points 1988-89 and 1997-98. The results indicate that use of ambulatory dental care has increased dramatically for children. In 1983, 38.5% of children had no dental care within the previous 12 months; and by 2001-02, 26.3% of children reported no dental care in the previous 12 months, a 12% reduction during the study period. Frequency of unmet dental care remained unchanged between the 1997-98 and 2001-02 point.;These study results provide further evidence that expansions of public health insurance have improved the health and health outcomes of America's children, and that the expansions represent an important public health accomplishment for children living in low-income families.