Health Insurance for Children:

State and Private Programs Create New Strategies to Insure Children

HEHS-96-35: Published: Jan 18, 1996. Publicly Released: Feb 20, 1996.

Additional Materials:

Contact:

Office of Public Affairs
(202) 512-4800
youngc1@gao.gov

Pursuant to a congressional request, GAO reviewed state and private efforts to insure children who are not eligible for Medicaid and whose parents cannot purchase private insurance, focusing on: (1) enrollment, costs, funding sources, and annual budgets of these state and private programs; (2) state strategies to manage costs while providing children access to health care; and (3) program design elements that have facilitated program implementation.

GAO found that: (1) by 1995, 14 states and at least 24 private-sector entities had programs to increase health care access for uninsured children; (2) the number of children enrolled in the state programs reviewed ranged from 5,000 to over 100,000 children and state budgets ranged from $1.7 million to $55 million; (3) private-sector programs enrolled up to 6,000 children and had budgets of $100,000 to $4.3 million; (4) state program funding sources included state general revenues, donations, and small insurance premiums and copayments; (5) budget limitations have reduced the number of Medicaid-eligible children served and have forced these programs to cap enrollment and place eligible children on waiting lists; (6) the programs' per-child costs ranged from $20 to $70.60 per-month; (7) state programs have attempted to reduce costs by limiting eligibility and covered services, relying on Medicaid to provide inpatient care, and using patient cost-sharing, managed care, and competitive bidding among insurers; (8) state efforts to attract providers included using insurers' existing payment systems and physician networks and paying near-market reimbursement rates, while their efforts to attract families included guaranteeing patient access to providers, having simple enrollment procedures, and avoiding the appearance of a welfare program; and (9) surveys showed that families were generally satisfied with state insurance programs, since the programs increased childrens' access to appropriate health care services.

Sep 28, 2016

Sep 15, 2016

Sep 14, 2016

Sep 12, 2016

Sep 9, 2016

Sep 6, 2016

Aug 31, 2016

Looking for more? Browse all our products here