State Children's Health Insurance Program

Idaho implemented numerous Medicaid policy changes under authority granted by the Deficit Reduction Act of 2005, which allowed greater flexibility in benefit design and cost-sharing. This case study describes these changes and explores their impacts, along with the political, regulatory, and institutional environments that shaped these impacts. While Idaho succeeded in meeting some of the original goals of the policy changes, further Medicaid changes would be needed to have major impacts on costs and beneficiary behaviors; however, such changes will likely be heavily dependent on how Idaho weathers the current economic downturn and on the policy changes the state makes associated with federal health reform efforts.

Kentucky implemented numerous Medicaid policy changes under authority granted by the Deficit Reduction Act of 2005, which allowed greater flexibility in benefit design and cost-sharing. This case study describes these changes and explores their impacts, along with the political, regulatory, and institutional environments that shaped these impacts. While Kentucky succeeded in meeting some of the original goals of the policy changes, further Medicaid changes would be needed to have major impacts on costs and beneficiary behaviors; however, such changes will likely be heavily dependent on how Kentucky weathers the current economic downturn and on the policy changes the state makes associated with federal health reform efforts.

The Covering Kids and Families program was a national initiative of the Robert Wood Johnson Foundation to reduce the number of eligible but uninsured children and adults through enrollment in Medicaid and SCHIP. This report presents trends in media use and in-person outreach conducted by state grantees and local projects funded through the initiative. While grantees faced funding and staffing limitations, demand for their services remained high due to decreases in state-funded outreach. Grantees stretched their resources by partnering with other organizations, relying heavily on media outreach to reach large numbers of families, and performing outreach at already-established events.

Health reform is expected to have a number of positive effects on the lives of children age 18 and under. Millions of uninsured kids are likely to gain coverage through either Medicaid or the new health insurance exchanges. Expanded coverage for parents will also increase children's coverage and access to care. New requirements on private plans, increased Medicaid reimbursement for primary care, and investments in public health and prevention will also likely have positive effects on children. Updated 7/28/10

This analysis shows that pediatric hospitalization rates are low both nationally and in Los Angeles County in comparison to adult hospitalization rates, and have gradually declined since 2000. This downward trend shows the impact of changes in the health care system that increasingly emphasizes ambulatory care and prevention over inpatient care. ACSC hospitalization rates decreased in Los Angeles, for both low- and high-income groups after the CHI was implemented (February 2003) compared to before implementation. Disparities, however, remain, and more work is needed to help close the gap in access to care for low income families in Los Angeles. Los Angeles: University of Southern California. July 2009.