To examine the impact of changing from a passive renewal process to an active renewal process in Florida's State Children's Health Insurance Program (SCHIP) on disenrollment, the researchers looked at administrative records, containing enrollment and demographic data, from January 2004 through February 2006. Children faced almost a 10-fold greater risk of disenrolling in their renewal month under active renewal than under passive renewal. They did not detect differential impacts of the policy change across children with different health status levels.

This brief reports on new research that indicates that increasing the continuity of children’s Medicaid coverage reduces subsequent hospitalizations for chronic health conditions like asthma or diabetes.  The research—a new study conducted by Dr. Andrew Bindman and his associates at the University of California at San Francisco—indicates that improving the continuity of Medicaid coverage through 12-month continuous eligibility can improve children’s health and avert unnecessary hospitalization costs.

Children fail to enroll and/or lose coverage primarily due to misinformation, difficult enrollment and renewal procedures, and inefficient administrative practices. This report explores how technological innovations can be applied to remove these impediments for Medicaid and SCHIP enrollment and retention, while at the same time making the programs more efficient.

This report illustrates the many creative and collaborative ways the Covering Kids & Families coalitions worked to break down barriers to public health coverage for low-income children and adults. From 1997-2002, these coalitions encouraged the adoption of outreach, simplification, and coordination strategies across the states. 

In March 2006, the National Academy for State Health Policy convened a small symposium on child health coverage consisting of state and national public and private sector experts on child health coverage. This brief summarizes key suggestions which emerged during the symposium discussion about lessons learned over the past decade of state efforts to increase rates of child health coverage. Meeting highlights are supplemented with additional information from the current literature, and examples from states.

This report examines the extent, causes, and consequences of instability in public coverage programs for children and families, focusing particularly on the phenomenon of “churning,” which occurs when individuals lose and regain coverage in a short period of time. It also provides strategies that can make public program coverage more stable.

This report reviews the impact of "churning" in California. It finds that over 600,000 children enrolled in Medicaid (Medi-Cal in California) in 2003 had been disenrolled from the program within a three-year period, only to be later re-enrolled. It cost California over $120 million to re-process these eligible Medi-Cal children.

Even as states made headway in enrolling eligible children, anecdotal evidence emerged as early as mid-1999 that large proportions of SCHIP enrollees were losing eligibility, or disenrolling, at the end of their period of coverage. The Urban institute collected information from eight states about their application and eligibility redetermination processes under SCHIP, as well as data on the outcomes of these processes. This report focuses on our findings related to retention.

This report examines reasons why many low-income individuals lose coverage, the effects of insurance loss, and strategies that can help people retain coverage. It shows that every person with public or private coverage at the beginning of a given year retained coverage throughout the next 12 months, the number of low-income children who are uninsured would decline by close to two-fifths over the course of a year. The number of uninsured low-income adults would decline by more than one-quarter.

This issue brief reports on a study of disenrollment from SCHIP by the Child Health Insurance Research Initiative (CHIRI). Looking at disenrollment in Florida, Kansas, New York, and Oregon the authors found that the administrative requirements imposed by states at renewal lead a large share of children to be dropped from coverage. In particular, results show that there is a strong and large association between disenrollment and recertification and that states without passive re-enrollment, approximately one-half of those enrolled at the
time dropped out of SCHIP.

NASHP—with seven states, Alabama, Arizona, California, Georgia, Iowa, New Jersey, and Utah—undertook a project to examine SCHIP disenrollment and how to retain enrollment of those children who continued to be eligible for the program but failed to complete the renewal process or make their premium payments. It provides results from a telephone survey of parents of current SCHIP enrollees and those those who have a lapse in coverage.