The 2010 Patient Protection and Affordable Care Act expands health insurance to millions of individuals, including many parents. New insurance options for parents raise a question about whether providing health insurance to parents benefits their children. The Children¿s Health Insurance Program Reauthorization Act of 2009 required this assessment of: (1) the extent to which a parent¿s health insurance status is associated with a child¿s health insurance status, use of services, and parental satisfaction with their child¿s care; and (2) how selected states¿ parent coverage under Medicaid and CHIP may change given upcoming expansions. Charts and tables. This is a print on demand edition of an important, hard-to-find publication.

The State Children's Health Insurance Program (SCHIP) was established by Congress to provide health insurance to uninsured children whose family income was too high for Medicaid coverage but too low to allow the family to obtain private health insurance coverage. The enabling legislation for SCHIP, included in the Balanced Budget Act of 1997, made available to states (and the District of Columbia) almost $40 billion over a 10-year period for this program. Like Medicaid, SCHIP is a joint federal-state program, with funding from both sources, but it is implemented by the states. Thus, there are SCHIP programs in all of the states and the District of Columbia. The National Research Council, through the Committee on National Statistics, was asked to explore some of the ways in which data analysis could be used to promote achievement of the SCHIP goal of expanding health insurance coverage for uninsured children from low-income families. To inform its work, the panel for this project held a workshop to bring together state SCHIP officials and researchers to share findings and methods that would inform the design, implementation, and evaluation of SCHIP at the state and national levels. In keeping with this charge, this report is limited to discussions at the workshop. It does not attempt to provide a summary of all the state programs nor a comprehensive review of the literature. Data Needs for the State Children's Health Insurance Program concludes that data are insufficient in the individual states to provide a clear picture of the impact of SCHIP on the number of children who are eligible for the program, the rate at which eligible children are enrolled in the program, and the rate at which they are retained in the program once enrolled. This situation is due, in part, to the fact that sample sizes in national surveys are too small to provide detailed data for individual states. In addition, the great amount of movement of children among health insurance categories-Medicaid, SCHIP, private insurance, or no insurance at all-makes it difficult for states to count the number of children in specific categories at a particular point in time. The panel specifies a number of practices that could be implemented to improve the overall functioning of SCHIP and the ability of policy makers to evaluate the program. Foremost among these are: (1) developing more uniform ways of estimating eligibility and health insurance coverage among the states; (2) sharing among the states effective methods for outreach; (3) taking qualitative information into account, in addition to quantitative information, in assessing variation among states in enrollment and disenrollment; and (4) implementing longitudinal studies to track the movement of children among the various insurance statuses.

Medicaid is among the nation's largest purchasers of health services, spending $432 billion in fiscal year (FY) 2011 on health care and long-term services and supports (LTSS) for 70 million enrollees. IN the same year, the State Children's Health Insurance Program (CHIP) made expenditures of nearly $12 billion on behalf of 8 million children. Medicaid enrollees are an especially diverse group – including low-income children and adults, pregnant women, persons with life-long disabilities, and seniors – some of whom are relatively healthy and others who are high users of acute care and LTSS. Medicaid plays a critical role for its enrollees, and it also plays a significant role in the health care system, helping to provide access for millions of people who would otherwise remain uninsured or underinsured, improving population health, and shoring up other payers by covering some of the nation's highest-need and highest-cost patients. As part of its statutory charge, each June the Medicaid and CHIP Payment and Access Commission (the Commission) reports on its review of the Medicaid and CHIP programs within the context of the health care system. This Report to the Congress focuses on issues that are central to the goals of the Medicaid program, including obtaining value as a purchaser of health care services, monitoring enrollees' access to services, and evaluating access to care for non-elderly adults. In support of Medicaid and CHIP policy analysis, the Report also includes Medicaid and CHIP Program Statistics (MACStats), which provides statistics on program enrollees and spending. MACStats is based on both federal administrative data and survey data, providing a detail profile of the Medicid and CHIP programs in a single source. The Report is divided into several sections and a statistical supplement. Access and Value: Issues for Medicaid and CHIP as Purchaser focuses on the role of Medicaid and CHIP as significant purchasers of health care and on the goal of achieving value within the programs. Data Sources for Monitoring Access to Care in Medicaid and CHIP identifies principles for developing a monitoring approach focused on both immediate and ongoing access issues. Access to Care for Non-Elderly Adults presents new analysis evaluating access to care, by comparing non-elderly adults enrolled in Medicaid with those having employer-sponsored insurance and those who are uninsured. MACStats presents updated data on the Medicaid and CHIP populations, Medicaid enrollment and benefit spending, and Medicaid managed care. MACStats sections include: Trends in Medicaid Enrollment and Spending; Health and Other Characteristics of Medicaid/CHIP Populations; Medicaid Enrollment and Benefits Spending; Medicaid Managed Care; and Technical Guide to the June 2012 MACStats.