SCHIP finds success in enrolling kids, pleasing parents

States have boosted enrollment in the Medicaid-alternative program to 4.6 million children.

By Amy Snow Landa, amednews staff. Feb. 25, 2002.

Washington -- In its first three years, the State Children's Health Insurance Program appears to have made steady progress in enrolling eligible children while also earning high marks from their parents.

About 4.6 million children were covered under SCHIP during fiscal year 2001, according to the Centers for Medicare & Medicaid Services. The program covers low-income children who do not qualify for Medicaid.

Covering children

The new figure, released in February, reflects a 38% increase over the 3.3 million children who were enrolled in fiscal year 2000, CMS officials said.

The latest numbers show that state and federal efforts to boost outreach and enrollment are paying off, the Bush administration said.

"Since President Bush took office, we have given states more flexibility and freedom to develop SCHIP plans that best meet the needs of their residents," said Health and Human Services Secretary Tommy Thompson. The new enrollment numbers "show our strategy is working."

In addition, the administration attributes the increase to efforts by the states to expand their SCHIP programs and streamline enrollment.

Before SCHIP, only six states covered children with family income above 200% of poverty.

Trish Riley, executive director of the National Academy of State Health Policy, agreed.

The new enrollment figure "certainly reflects that the hard work of states is working and the program is a success," she said.

SCHIP coverage is now available in 38 states and the District of Columbia for children up to age 19 whose family income is at or above 200% of the federal poverty level ($17,650 for a family of four). Other states have SCHIP programs but cover children at lower family income levels. Prior to Congress enacting SCHIP, only six states covered children whose family income was at or above 200% of poverty, and that was for infants only.

Physicians, hospitals and health clinics -- who have strongly supported the program -- have also been very involved in signing up eligible children for SCHIP.

SCHIP also appears to be a success in the eyes of parents. Both parents whose children are currently enrolled and those whose children have left it gave the program high marks in a recent telephone survey by NASHP.

The survey found that among parents whose children are current enrollees, 83% rated SCHIP as an "excellent" or "very good" program.

38% more children were enrolled in SCHIP in 2001 than in 2000.

The survey was conducted in the summer of 2001 and included 3,780 parents in seven states: Alabama, Arizona, California, Georgia, Iowa, New Jersey and Utah.

Even parents who let their children's enrollment lapse reported positive views of SCHIP, the survey found.

In fact, 84% of lapsed families said they would "definitely" want their children back in the program if they were eligible. Among parents whose children are now covered under private insurance, 83% said they would definitely want their children back in SCHIP if they were eligible.

Parents who gave SCHIP a positive assessment typically said they appreciated the program's affordability most, but that they also liked its comprehensive coverage, the access it provided to doctors and specialists, and the high-quality medical care their children received.

But survey findings indicate that parents do not necessarily take their child to the doctor for preventive check-ups once their child is enrolled in SCHIP.

More than half (53%) of parents of enrolled children said they take their child to the doctor "only if he/she is sick or injured," while 45% said they take their child "for check-ups even if he/she is 100% healthy."