The 2010 health reform bill, the Patient Protection and Affordable Care Act, included a provision that would expand eligibility of the public insurance program Medicaid. One concern raised about implementing the Medicaid expansion is that it would lead to reductions in state spending in other policy domains. In this study, we test whether adopting…

Importance: Children experiencing parental opioid use disorder are a growing population at heightened risk of physical and mental health issues over the life course. Yet these children are less likely to receive comprehensive, ongoing health care and their parents are more likely to report barriers to access health care for their children.…

The Home and Community Based Services (HCBS) settings rule (CMS 2249-F/2296-F) strictly enforces meaningful community-based settings for those receiving Medicaid HCBS funding. Stakeholders have the opportunity to impact states' setting rule plans and hold states accountable to ensure rules are truly community based. Yet, the complex rule can be…

The purpose of this study was to examine the characteristics of Part C programs and how funding has impacted the quality of services for children and families given ongoing budgetary concerns. Perceptions of State Early Intervention Coordinators (EICs) regarding their state Part C systems were obtained through an online survey. Using survey…

Teacher benefits, once a sleepy question primarily of interest to actuaries, have become a flash point in the education debate. With individual states on the hook for tens or hundreds of millions in unfunded pension and health insurance obligations, state leaders are trying to determine the severity of the situation and the appropriate response.…

Newborn screening is a test done on every child born in the US shortly after birth to detect diseases where, if not diagnosed and treated in the newborn period, the child will suffer significant trauma, disability or die. A few drops of blood from each baby's heel is put on a card and sent to the state's public health lab for testing. Most states…

Application inconvenience is one popular explanation for why many individuals do not receive the social benefits for which they are eligible. Applications take time and some individuals may decide that the financial benefits do not outweigh these time costs. This paper investigates this explanation using cross-state variation in administrative…

Many Medicaid programs have either fully or partially carved out mental health services. The evaluation of carve-out plans requires a case-mix model that accounts for differing health status across Medicaid managed care plans. This article develops a diagnosis-based case-mix adjustment system specific to Medicaid behavioral health care. Several…

Enacted in 1997, the State Children's Health Insurance Program (SCHIP) represented the largest expansion of U.S. public health care coverage since the passage of Medicare and Medicaid 32 years earlier. Although the program has recently been reauthorized, there remains a considerable lack of thorough and well-designed evaluations of the program. In…

Purpose/Objectives: The Direct Verification Pilot tested the feasibility, effectiveness, and costs of using Medicaid and State Children's Health Insurance Program (SCHIP) data to verify applications for free and reduced-price (FRP) school meals instead of obtaining documentation from parents and guardians. Methods: The Direct Verification Pilot…

We evaluate the effects of state policy design features on SCHIP take-up rates and on the degree to which SCHIP benefits crowd out private benefits. The results indicate overall program take-up rates of approximately 10 percent. However, there is considerable heterogeneity across states, suggesting a potential role of inter-state variation in…

To address the health care needs of the millions of uninsured children of low-income families ineligible for Medicaid, many states have developed innovative public and private programs. Examines the privately funded Blue Cross/Blue Shield Caring Program and promising public programs in 11 states. (MDM)

Evaluation of changes in Maryland's unemployment insurance (UI) program found that duration and amount of UI receipt were reduced by requiring additional employer contacts or a job-search workshop; these requirements did not affect employment and earnings. However, eliminating employer contact requirements increased UI receipt and subsequent…

Describes the current status of the State Children's Health Insurance Program (SCHIP), examining roles that school enrollment-based health insurance (SEBHI) programs play in three states and summarizing lessons SEBHI programs can offer SCHIP as states work toward full implementation. SEBHI programs are an important model leading to more…

State Medicaid expenditures for Intermediate Care Facilities for the Mentally Retarded (ICF-MR) increased sharply between 1980 and 1984. The ICF-MR bed capacity declined relative to the total state population, while numbers of ICF-MR Medicaid recipients increased. Trends among states are examined, emphasizing changes in demographic factors,…