New SCHIP enrollees have unmet health care needs

Waiting period would negatively affect health status of enrollees

Even with prior private health insurance, patients enrolling in the state children’s health insurance program (SCHIP) had unmet health care needs. Instituting a waiting period would further prolong these children’s need to address asthma and other chronic health conditions.

To deter crowd-out, which happens when patients switch to SCHIP when they have the option of private insurance, 35 states require waiting periods to qualify for SCHIP. Waiting periods require uninsured children to go with no insurance for a specified period of time before allowing them to enroll in the state program. New York state’s Child Health Plus SCHIP has never instituted a waiting period. Because of that, the program presents a unique opportunity to study the patients who switch from private insurance.

“First of all, we’ve found that few families switch their children to SCHIP when they have the option of private health insurance – in fact, only 7 percent do,” said Laura Shone, Dr.P.H., M.S.W., an assistant professor of pediatrics at the University of Rochester Medical Center and author of the study being presented during a presidential plenary session at the Pediatric Academic Society meeting in Honolulu, Hawaii, today. “And second, those who do switch have the same unmet health care needs as those who didn’t have insurance when they enrolled.”

Shone said this study shows that families are not “saving up” health problems for SCHIP to address after enrollment. It also shows that waiting periods could harm even those children who have had private insurance. About 57 percent of children, both with and without prior insurance, had unmet health care needs when enrolling in SCHIP. In fact, 10 percent of those who had prior private insurance had asthma and about 7 percent had some other chronic health condition.