Access to Care in the State Children's Health Insurance Program (SCHIP)

Abstract

The State Children's Health Insurance Program (SCHIP) was clearly successful in reducing the number of uninsured children, but it is less clear how SCHIP affects children's access to and utilization of health care services. This study used a modified difference-in-difference approach to examine the effect of SCHIP on children's access to care. Data from Mississippi and Alabama were analyzed in 1997 before SCHIP funds were available to states and in 1999 when only Alabama had implemented a separate SCHIP program. Results indicate that SCHIP improved the number of children with a usual source of care by over five percentage points, while also decreasing the probability that a child used the emergency room. Interestingly, and contrary to theory, SCHIP also decreased the probability that a child saw a dentist. While these results generally support the intent of SCHIP, they also indicate some weaknesses in the program that should be further investigated as Congress prepares for SCHIP reauthorization in 2007.