The Impact of the State Children\u27s Health Insurance Program (SCHIP) on Community Health Centers

Nearly 12 million children in the United States do not have health insurance, and therefore often lack access to health care. In response, Congress enacted the State Children’s Health Insurance Program (SCHIP) in August 1997, the largest expansion of health insurance coverage since the inception of the Medicare and Medicaid programs. The SCHIP provides states with federal matching funds for children’s insurance either by expanding the existing Medicaid program, by creating a separate state program, or a combination of both. The George Washington University’s Center for Health Services Research and Policy (CHSRP) was funded by the Health Resources and Services Administration (HRSA) to evaluate SCHIP’s impact on the insurance status of children served by select HRSA programs, as well as its impact on HRSA grantee organizations. The research has two primary goals: 1) to document the extent of health insurance volatility experienced by users of the health centers covered by SCHIP versus Medicaid; and 2) to determine whether and how SCHIP has impacted safety net providers such as community health centers (CHCs) and Title V maternal and child health (MCH) programs. The study focused on the experience of community health centers (CHCs), and examined three groups of children: 1) children who continue using the HRSA site after enrolling in SCHIP; 2) children who are new to the HRSA sites; and 3) children who were previous users but are no longer visiting the HRSA site. Five research questions provide the analytic framework for conducting the research and data analysis: 1) What effect has SCHIP had on parents’ ability/willingness to obtain SCHIP for their children? 2) What effect has SCHIP had on children’s health insurance volatility? 3) What effect has SCHIP had on parents’ ability/willingness to seek health services for their children at a CHC site? 4) What has been SCHIP’s effect on CHC sites? and 5) What effect has SCHIP had on parents’ ability/willingness to seek health services for their children from other providers