This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health,

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Presentation transcript:

This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health, Prime Contract No. 1 P09 OA Sub-Contract Research Corporation of the University of Hawaii, Project No Research conducted by the University of Hawaii, Social Science Research Institute in collaboration with the Hawaii State Department of Health, Hawaii Institute for Public Affairs/Hawaii Uninsured Project and the Hawaii Health Information Corporation. Public Insurance Expansion: Children Age 0-18 Gerard Russo Sang-Hyop Lee Lawrence Nitz Thamana Lekprichakul Abdul Jabbar Rui Wang University of Hawai`i at Mānoa Hawai`i Coverage for All Project Technical Workshop V 29 March 2004

This research is funded in part through a U.S. Health Resources and Services Administration, State Planning Grant to the Hawaii State Department of Health, Prime Contract No. 1 P09 OA Sub-Contract Research Corporation of the University of Hawaii, Project No Research conducted by the University of Hawaii, Social Science Research Institute in collaboration with the Hawaii State Department of Health, Hawaii Institute for Public Affairs/Hawaii Uninsured Project and the Hawaii Health Information Corporation. POLICY SCENARIO: SCHIP EXPANSION Expand the eligibility requirement for the State Children’s Health Insurance Program for children aged 0-18 years from an upper limit of 200% to 300% of the Federal Poverty Level.

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. Hawaii Title XXI Program: SCHIP July 2000 SCHIP Hawaii children aged 0 to 18 years 200% of the FPL effective. Hawaii SCHIP is implemented as a Medicaid/QUEST expansion.

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. Hawaii SCHIP Program Eligibility by Age and Federal Poverty Level

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. SCHIP FMAP Federal Medical Assistance Percentage (FMAP) FFY % FFY %

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. MODEL FIT: Children Age 0-18, 0-200% FPL: HHS 2000,2001 ACTUALPREDICTED PROBABILITY UNINSURED 6.02%6.01% PRIVATE OTHERS 73.26% MEDICAID QUEST SCHIP 20.72%20.73%

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. Model-Based Prediction of Insurance Coverage Change due to a SCHIP Expansion to 300% FPL: HHS 2000, 2001 Status QuoExpansionChange Uninsured3.94%0.38%-3.56% Private Insurance 92.41%38.43%-53.98% Public Insurance 3.66%61.19%+57.54% Total100% 0%

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. Model-Based Prediction of Insurance Coverage Change due to SCHIP Expansion: HHS 2000,2001 (persons) Status Quo ExpansionChange Uninsured Private Insurance 47,08019,578-27,502 Public Insurance ,177+29,314 Total50,948 0

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. Two Methods of Analyzing SCHIP Expansion Using the Hawaii Health Survey and the Current Population Survey Model-Based Out-of-Sample Predictions: HHS, CPS Natural Experiment Based on July 1, 2000 Expansion Pre-Expansion Years: HHS , CPS Post-Expansion Years: HHS , CPS Difference-in-Differences Approach Compute take-up and crowd-out rates Extrapolate to the new target population % FPL

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. Children’s Health Insurance Coverage Before and After SCHIP: HHS Health Plan Medicaid Eligible SCHIP Ineligible % FPLTotal Medicaid Eligible SCHIP Eligible % FPLTotal Uninsured5,0453,2142,25810,5183,7463,5811,6999,026 Medicaid Quest SCHIP13,4804,9762,70021,15518,7206,9333,13028,783 Private & Others56,38651,99553,246161,62741,72854,09061,018156,836 Total74,91160,18558,204193,30064,19464,60465,847194,645

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. Children’s Coverage Rates Before and After SCHIP: HHS Health Plan Medicaid QUEST Eligible SCHIP Ineligible % FPLTotal Medicaid QUEST Eligible SCHIP Eligible % FPLTotal Uninsured Medicaid QUEST SCHIP Private & Others Total 100

29 March 2004 Preliminary results. Subject to further revision. Please do not quote. SCHIP Analysis: CPS Survey year Health Plan Medicaid QUEST EligibleSCHIP % FPLTOTAL PersonsRate%PersonsRate%PersonsRate%PersonsRate% Uninsured Private & Others Medicaid QUEST SCHIP Total Uninsured Private & Others Medicaid QUEST SCHIP Total