This two-part report examines why the Children's Medical caseload declined
following a series of eligibility policy changes implemented in April
2003. The changes included new signature and income verification
requirements, a 6-month eligibility review cycle, and termination of
12-month continuous eligibility.
Part I of this study examined administrative data and found a net
decline of 39,085 children on the Children's Medical caseload in the 18
months following the eligibility policy changes. Most of the loss of
coverage was attributable to increased exits, as opposed to few newer
entries or increased cycling off and on the caseload.
Part II of this study used client survey data to better understand why
children left the Children's Medical program after the policy changes.
Key findings include:
Do children leaving the Children's Medical caseload have non-DSHS
medical coverage? If not, are they still eligible for DSHS coverage?
Most "leavers" (60 percent) had non-DSHS coverage at the time of the
interview, but almost all uninsured "leavers" were still eligible for
DSHS coverage.
Why did the DSHS eligible but uninsured children leave? And do
they plan to return? Most parents say DSHS made the decision, and
about half cite administrative-related reasons. Almost all parents say
they plan to reapply for Medicaid.
Do the DSHS eligible but uninsured differ from the kids who exited
to other medical coverage? They are poorer, more likely to use the
emergency room, less likely to have physician or clinic visits, and
more likely to be Hispanic.
What might have been the consequences of maintaining 12-month
continuous eligibility? The 36 percent of "leavers" who were DSHS
eligible but lost coverage and were uninsured would likely have
remained on Medicaid for another 6 months. The 32 percent of leavers
who were "ineligible" would likely have continued on Medicaid for
another 6 months.
Are there opportunities to identify more children on Medicaid with
private coverage? Many "leavers" who remained DSHS eligible had other
coverage when interviewed. Enhanced efforts to coordinate benefits or
buy into employer-provided coverage may be warranted.
Download
Click on the PDF
symbol to the left and download reports.
FULL REPORT: "Children's
Medical Caseload: Why the Decline?"
Publication Date: 08/2005. Report Number 9.74. (KB 500)
PART I: "A Look at the Administrative Data"
Publication Date: 08/2005. Report Number 9.74a. (KB 178)
PART II: "What the Survey Findings Tell Us"
Publication Date: 8/2005. Report Number 9.74b.
(KB 229)
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and Health Services, go to
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Copyright 2007 Washington State Department of Social and Health Services.
Children's
Medical Caseload:
