By Martha Heberlein
Most of you know the CPS – the annual social and economic supplement (ASEC) has been our go to source for health insurance coverage on a national and state-by-state basis for years. However, given the nature of the sample, analysis has been somewhat limited, especially for those smaller states and for those interested in data on a sub-state level.
Now there’s a new kid on the block. In 2008, a question on health insurance coverage was added to the American Community Survey. Like the CPS, the ACS is a national survey, but it has a much larger sample size (the CPS looks at about 78,000 households annually, whereas the ACS surveys 250,000 per month). It may seem somewhat counterintuitive, but the bigger the sample size, the smaller the area (geographic or demographic) that you can examine. We may just be able to get answers to some of those long-standing research questions.
One such question that has long plagued those of us looking to enroll eligible children in Medicaid and CHIP is: who are those kids and where can we find them? Thanks to the ACS (and some very talented folks over at the Urban Institute) we now have a much better idea, as today in Health Affairs, Dr. Genevieve Kenney and her colleagues released a paper that looks at that very question. (The report will also be highlighted at a media event today where HHS Secretary Sebelius will relaunch her Connecting Kids to Coverage Campaign. You can watch it live here).
They found that of the 7.2 million uninsured children in the U.S., 4.7 million or 65% were eligible for Medicaid or CHIP. Of those, about a third are concentrated in just three large states (California, Texas, and Florida), a piece of data that certainly highlights the need for outreach and enrollment efforts in those states.
But I think an equally appropriate (and far more upbeat) view of the data is the success states have had enrolling children in their Medicaid and CHIP programs. Nationwide, the participation rate in Medicaid and CHIP is 82% (high compared to other means-tested programs). And 11 states were shown to have participation rates that were close to or above 90%. Those are amazing numbers and states should celebrate their well-deserved accomplishments.
For those of you doubters who say, “well, that could never happen in my state,” I beg to differ. To quote the authors: “since these states constitute a diverse group in terms of their size, income distribution, racial and ethnic composition, and region, it suggests that high participation rates can be achieved across a range of different circumstances.” In other words, while it is certainly not easy to get all the eligible kids in your state covered, there are plenty of places to look to as role models, and ones that may be very much like your own.