Federal funding for the Children’s Health Insurance Program (CHIP) ended in September 2017. This caused a stir as many parent’s relied on CHIP for their children’s health insurance. In January 2018, however, the federal government’s passed a six-year CHIP funding extension and resolved to continue to fund this program. The headlines at the time showed pictures of worried parents and children, but is CHIP really that important to families? Do they really want to take up this insurance, or do parents consider it second-rate coverage?
A study by Haley et al. (2018) seeks to answer the question. They look at CHIP take-up rates using data from the American Community Survey (ACS) Public Use Microdata Sample (PUMS). While the ACS is a nationally representative survey, it is based on respondent self-report which is a concern.
Using this approach, the authors find that:
In 2016, 93.7 percent of eligible children without other coverage were enrolled in Medicaid/CHIP, a rate that was 5 percentage points higher than in 2013 (88.7 percent)…Medicaid/CHIP programs reached over 90 percent of their target population of children in all but five states (Alaska, Indiana, North Dakota, Texas, and Utah)…and participation was above 97 percent in four states (Massachusetts, Rhode Island, Vermont, and West Virginia).
As a point of comparison. These rates of take-up for children are much higher than adult take-up of Medicaid health insurance. Overall, Medicaid take-up among adults was 79.9% (vs. 93.7% for children). The adult Medicaid take-up rate did vary dramatically with adult take-up rates falling below 60% in Alaska, Georgia, Nebraska, Oklahoma, and Texas but reaching to more than 94% in Massachusetts and Vermont.
The authors do note that Medicaid take-up was higher in ACA expansion states than in nonexpansion states. The differences in children’s take-up across expansion and non-expansion states was fairly small, but the differences in take-up among parents in expansion states was much higher than among parents in non-expansion states.
In short, it appears that Americans’ particularly the parents of children eligible for CHIP, do truly value health insurance coverage for their children as CHIP take-up rates are very high.
- Genevieve M. Kenney, Robin Wang, Victoria Lynch, and Matthew Buettgens. Medicaid/CHIP Participation Reached 93.7 Percent Among Eligible Children In 2016. Health Affairs 2018. 37:8, 1194-1199