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Health Insurance and Access to Care for Children and Adolescents
Knowledge Path

Introduction

This knowledge path about child and adolescent health insurance and access to care has been compiled by the Maternal and Child Health Library at Georgetown University. It offers a selection of current, high-quality resources that analyze data, describe effective programs, and report on policy and research aimed at advancing health coverage and improving health care access for children and adolescents. Emphasis is placed on Medicaid and the Children's Health Insurance Program (CHIP). Separate sections present resources for professionals (health professionals, program administrators, policymakers, and researchers) and for families. A special topics section presents resources that address health reform, outreach and enrollment, and school-based and school-linked care. This knowledge path will be updated periodically.

Please note: The Children's Health Insurance Program Reauthorization Act (CHIPRA) of 2009 extends and expands the State Children's Health Insurance Program (SCHIP) enacted in 1997. CHIPRA refers to the program as CHIP, not SCHIP. Several publications in this knowledge path were published before CHIPRA was signed into law, and therefore, use the acronym SCHIP.

Overview

See Covering Health Issues, 5th ed (2010), a briefing book by the Alliance for Health Reform. Chapter 6 addresses children's health coverage and offers facts, background information, policy debate summaries, tips and story ideas for reporters covering this topic, and a list of experts with contact information.

General Resources for Professionals

Web Sites

• Agency for Healthcare Research and Quality (AHRQ). Evidence-based information on health care outcomes; quality; and cost, use, and access. Resources and initiatives include
  
  Child Health Care Quality Toolbox: Measuring Quality in Children's Health Programs. Tips and tools to help state and local policymakers and program administrators evaluate Medicaid, CHIP, Title V, and other health programs for children and adolescents.
  
  Children's Health Care Quality. Activities and resources related to the quality provisions of CHIPRA. Presents a core set of children's health care quality measures for voluntary use by Medicaid and CHIP programs.
  
  Child Health Insurance Research Initiative (CHIRI™). Program information and research findings for policymakers to help them improve access to, and the quality of, health care for children and adolescents from families with low incomes.
  
  Impact of Primary Care Case Management (PCCM) Implementation in Medicaid and SCHIP. (2009). [Issue brief].
  
  What Has Been Learned About Expanding Children's Health Insurance? (2009). [Issue brief].
  
  Also see the Healthcare Cost and Utilization Project (HCUP), Medical Expenditure Panel Survey (MEPS), and National Quality Measures Clearinghouse™ (NQMC).
  
  
• Alliance for Health Reform: Child Health Insurance. Webcasts, transcripts, and background materials about child and adolescent health insurance and access to care. The alliance is a nonpartisan, nonprofit group aiming to inform policymakers, journalists, and advocates about health coverage issues. Recent resources include
  
  Children's Health Coverage: Medicaid, CHIP, and Next Steps. (2009). [Webcast, Podcast, Transcript, Meeting Summary, Background materials].
  
  
• American Academy of Pediatrics (AAP). Initiatives and resources that address child and adolescent health insurance and access to health care include
  
  2009 Pediatric Medical Cost Model, rev. ed. (2009). This is an actuarial analysis of net medical costs paid by insurers for physician services for children during 2008.
  
  2009 State Legislation Report. (2010). This report outlines state legislative activity on 10 children's health issues including Medicaid, CHIP, and access to health care.
  
  Community Access to Child Health (CATCH) Program. Grant information and tools for this program to improve access to health care by supporting pediatricians and communities that are involved in community-based efforts for children.
  
  Healthy Tomorrows Partnership for Children Program (HTPCP). Information about this grant program to support community-based efforts to improve access to health care for families.
  
  Also see AAP's resources about health reform.
  
  
• Catalyst Center: Improving Financing of Care for Children and Youth with Special Health Care Needs. Reports, issue briefs, data, and PowerPoint presentations for policymakers, program administrators, and health professionals about improving health insurance and financing for children and adolescents with special health care needs. Catalyst is a national center located at the Boston University School of Public Health and funded by the Maternal and Child Health Bureau (MCHB). Recent resources include
  
  Breaking the Link Between Special Health Care Needs and Financial Hardship. (2009). [Report].
  
  State-at-a-Glance Chartbook on Coverage and Financing for Children and Youth with Special Health Care Needs. Data on selected indicators of health coverage and health care financing for children and adolescents with special health care needs in every state plus Washington, DC and Puerto Rico.
  
  Also see the Catalyst Center reports about health reform.
  
  
• Census Bureau. Data about health insurance coverage in the United States. Recent reports include
  
  Income, Poverty, and Health Insurance Coverage in the United States: 2008, rev. ed. (2009). [Report].
  
  
• Center for Children and Families (CCF). Analyses of federal policy developments and state-based initiatives affecting the health insurance coverage of America's families. CCF is an independent, nonpartisan policy and research center based at Georgetown University's Health Policy Institute. Recent resources include
  
  Children's Health Insurance Program Reauthorization Act of 2009: Overview and Summary. (2009). [Report].
  
  Five Reasons Not to Add Red Tape to Your Child and Family Health Programs. (2010). [Issue brief].
  
  State Resource Center. Fact sheets, statistics, in-depth analyses, and tools to assist states in advancing health coverage for children and families.
  
  Understanding the New Quality Initiatives in CHIPRA. (2010). [Issue brief].
  
  Weathering the Storm: States Move Forward on Child and Family Health Coverage Despite Tough Economic Climate (2009). [Report].
  
  Also see CCF's blog, health reform resources, and resources about outreach and enrollment.
  
  
• Center on Budget and Policy Priorities (CBPP): Health. Articles and analyses, podcasts, video, and background information about health reform and insurance coverage, including Medicaid and CHIP. CBPP is a nonpartisan research and policy organization that focuses on federal and state fiscal policy and public programs that affect families and individuals with low or moderate incomes. Also see CBPP's Start Healthy, Stay Healthy Campaign.
  
  
• Centers for Medicare and Medicaid Services (CMS). Information about Medicaid and CHIP, including program guidance and information about enrollment and coverage, demonstration projects, and special initiatives. Offers an overview of the EPSDT program, which provides comprehensive health services for infants, children, and adolescents enrolled in Medicaid and a fact sheet that describes the required services for EPSDT within each state's Medicaid program. Also see the speaker presentations and transcripts from the 2009 National Children's Health Insurance Summit.
  
  
• Commonwealth Fund. Reports, data, Webinars, podcasts, newsletters, and a blog on topics that include child and adolescent health and development, health insurance, state health policy, and health reform. The Commonwealth Fund is a private foundation supporting independent research on health care issues and making grants to improve health care practice and policy. A sample of recent publications include
  
  Building Medical Homes in State Medicaid and CHIP Programs. (2009). [Report].
  
  Getting and Keeping Coverage: States' Experiences with Citizenship Documentation Rules. (2009). [Report, charts].
  
  Implementation Choices for the Children's Health Insurance Program Reauthorization Act of 2009. (2009). [Report]. A Webinar followed the release of the report. View presentations and hear a recording from the event.
  
  Medicaid and CHIP Strategies for Improving Child Health. (2009). [Report, charts].
  
  
• Families USA. Background information, issue briefs, fact sheets, charts, state news, advocacy tools, a blog, and newsletters and about Medicaid, CHIP, CHIPRA, and health reform. Families USA advocates at the national, state, and community levels for high-quality, affordable health care for all Americans. Recent resources include
  
  CHIPRA Implementation Series: Exploring New Opportunities for Children's Coverage. [Issue brief series].
  
  Medicaid and Children's Health Insurance Program (CHIP) Eligibility by State. (2010). [Chart].
  
  Medicaid and the Children's Health Insurance Program (CHIP) Soften the Blow During Tough Economic Times. (2009). [Fact sheet].
  
  Medicaid: Making It Work for Consumers. Resources for consumer-assistance programs, states, and advocates to help consumers establish their eligibility for Medicaid and to get Medicaid to cover their health care needs.
  
  Summary of Final CHIP Reauthorization Bill. (2009). [Fact sheet].
  
  
• Health Resources and Services Administration/Maternal and Child Health Bureau (MCHB).
  
  EPSDT and Title V Collaboration to Improve Child Health. Information about EPSDT and about opportunities for collaboration between Title V and Medicaid to improve EPSDT services. Presents strategies for improving EPSDT administration and performance. Resources address systems of care issues, family supports, data monitoring, and evolving EPSDT policy.
  
  HRSA Medicaid Primer. Fact sheets to assist state and local health officials in understanding how Medicaid works and how it can ensure access to health services for underserved populations, including eligible infants, children, and adolescents.
  
  State MCH-Medicaid Coordination: A Review of Title V and Title XIX Interagency Agreements (2nd Ed). (2008). [Report].
  
  Also see the Title V Information System (TVIS), the Discretionary Grant Information System (DGIS), and the Maternal and Child Health Library.
  
  
• Insure Kids Now: For Professionals. Information, policy guidance, and data about Medicaid and CHIP. Includes CMS guidance on CHIPRA implementation and information about and tools to support outreach and enrollment efforts underway and funded by CHIPRA.
  
  
• Kaiser Family Foundation (KFF). An extensive collection of resources about children's health insurance coverage and care under Medicaid and CHIP, private health insurance, and health reform. KaiserEDU.org offers online tutorials and links to research, policy analysis, and data for faculty and students about Medicaid and CHIP, the uninsured, and health reform. KFF is a nonprofit, private operating foundation focusing on the major health care issues facing the United States, as well as the U.S. role in global health policy. A selection of recent publications includes
  
  Children's Health Insurance Reauthorization Act of 2009 (CHIPRA). (2009). [Fact sheet].
  
  CHIP TIPS. (2009). This series of briefs highlights opportunities for covering children under Medicaid and CHIP.
  
  Emerging Health Information Technology for Children in Medicaid and SCHIP Programs. (2008). [Report].
  
  Health Coverage of Children: The Role of Medicaid and CHIP. (2009). [Fact sheet].
  
  Impact of Medicaid and SCHIP on Low-Income Children's Health. (2009). [Policy brief].
  
  Medicaid Beneficiaries and Access to Care. (2009). [Fact sheet].
  
  Oral Health Coverage and Care for Low-Income Children: The Role of Medicaid and CHIP, rev. ed. (2009). [Policy brief].
  
  Protecting Children During the Recession: Spotlight on State Health Coverage Efforts. (2009). [Issue brief].
  
  Racial/Ethnic Disparities in Access to Care Among Children: How Does Medicaid Do in Closing the Gaps? (2009). [Report].
  
  Also see statehealthfacts.org, the Medicaid Benefits Online Database, Kaiser Health News, and resources about health reform and outreach and enrollment.
  
  
• Mathematica Policy Research, Inc. Data and analysis to inform decision making about health insurance coverage for children, including Medicaid and CHIP and national health reform. Mathematica, a nonpartisan research firm, conducts research and data collection to improve public well-being. Publications includes
  
  Covering Kids and Families Evaluation. Synthesis of 10 Case Studies: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice. (2009). [Report].
  
  National Evaluation of the State Children's Health Insurance Program: A Decade of Expanding Coverage and Improving Access. (2007). [Report].
  
  SCHIP Children: How Long Do They Stay and Where Do They Go? (2009). [Issue brief].
  
  
• National Academy for State Health Policy (NASHP). State policy and program information and analyses, research, and tools about health insurance coverage and access to care and health reform. NASHP is an independent academy of state health policymakers working together to identify emerging issues, develop policy solutions, and improve state health policy and practice. Also see NASHP's Maximizing Enrollment for Kids program.
  
  
• National Conference of State Legislatures (NCSL): Health. Background information, federal and state legislative news and bill summaries, issue briefs, reports, and multimedia resources for state policymakers about health insurance, access to health care, Medicaid and CHIP, and health reform. NCSL, an association of state lawmakers and legislative staff members, conducts research and offers technical assistance on state issues, including health policy.
  
  
• National Health Law Program (NHeLP). Fact sheets, issue briefs, case dockets, and legal transmittals about Medicaid and CHIP. NHeLP is a national public-interest law firm that aims to improve health care for families with low incomes, minorities, the elderly, and people with disabilities. Recent publications include
  
  Children's Health Insurance Program Reauthorization Act. (2009). [Analysis].
  
  Medicaid EPSDT Litigation. (2009). [Fact sheet].
  
  Also see NHeLP's Healthcarecoach.com.
  
  
• National Health Policy Forum. Issue briefs, papers, and glossaries about health insurance and the uninsured, Medicaid and CHIP, and health reform. NHPF is based at the George Washington University and offers educational programming designed to help congressional and federal agency staff become better informed about current health policy issues. Recent publications include
  
  Children's Health Insurance Program (CHIP): The Fundamentals. (2009). [Paper].
  
  Citizenship Documentation in Medicaid and CHIP. (2009). [Paper].
  
  
• Urban Institute (UI): Health Policy Center. Research and analysis about issues affecting child and adolescent health insurance, access to care, and health reform. UI is a nonpartisan economic and social policy research organization. See UI's publications about outreach and enrollment.
  

  

Additional Electronic Publications

• Allen K. 2008. Medicaid Managed Care for Children in Child Welfare. Hamilton, NJ: Center for Health Care Strategies, Inc. This issue brief describes the complex needs of children in child welfare and outlines how states and health plans can customize managed care to meet their needs.
  
  
• Bureau of Primary Health Care (BPHC). 2008. Health Centers: America's Primary Care Safety Net, Reflections on Success, 2002–2007. Rockville, MD: Health Resources and Services Administration (HRSA). This report describes federally funded safety net health center programs, populations served, services provided, the model of care used, financing, performance, community partnerships, and future challenges and opportunities.
  
  
• Chandra A, Gresenz CR, Blanchard JC, Cuellar AE, Ruder T, Chen AY, Gillen EM. 2009. Health and Health Care Among District of Columbia Youth. Santa Monica, CA: RAND Corporation. This report assesses health and health care use among more than 100,000 children and adolescents residing in Washington, DC. The report outlines key findings about health insurance, access to health care, and specific health conditions. An executive summary and related research brief are also available.
  
  
• Chay KY, Guryan J, Mazumder B. 2009. Birth Cohort and the Black-White Achievement Gap: The Roles of Access and Health Soon After Birth. Cambridge, MA: National Bureau of Economic Research. This paper examines data from average test scores and measures of health to analyze how access to health care when very young affects the later achievements of blacks relative to whites.
  
  
• Effros R. 2010. Analysis of Medicaid/SCHIP Eligibility. Santa Monica, CA: RAND Corporation. This report analyzes how expanding Medicaid/SCHIP eligibility would affect health system performance along nine dimensions.
  
  
• Government Accountability Office (GAO). 2010. Medicaid and CHIP: Enrollment, Benefits, Expenditures, and Other Characteristics of State Premium Assistance Programs. Washington, DC: Government Accountability Office. This report describes cost and coverage issues related to state premium assistance programs receiving Medicaid and CHIP funds.
  
  
• Government Accountability Office (GAO). 2009. Medicaid Preventive Services: Concerted Efforts Needed to Ensure Beneficiaries Receive Services. Washington, DC: Government Accountability Office. This report examines the provision of preventive services for children and adults in the Medicaid program, including the extent to which state Medicaid programs monitor and promote EPSDT services for children.
  
  
• Government Accountability Office (GAO). 2009. State Children's Health Insurance Program: CMS Should Improve Efforts to Assess Whether SCHIP Is Substituting for Private Insurance. Washington, DC: Government Accountability Office. This report describes the adequacy of efforts by CMS and states to measure and then minimize the number of individuals substituting SCHIP for private insurance, known as "crowd-out."
  
  
• Guttmacher Institute. 2010. Minors' Access to Prenatal Care. New York, NY: Guttmacher Institute. This fact sheet provides information about state laws regarding a minor's ability to access prenatal care. Also see the Guttmacher Institute's fact sheets, Minors' Access to Contraceptive Services (2010) and Minors' Access to STI Services (2010).
  
  
• Institute of Medicine (IOM). 2009. America's Uninsured Crisis: Consequences for Health and Health Care. Washington, DC: National Academies Press. This report examines the dynamics driving downward trends in health insurance coverage, the consequence of uninsurance to children and adults, and whether insured people are affected by high rates of uninsurance in their communities.
  
  
• King J, Slifkin R, Homes M. 2009. Characteristics of Rural and Urban Children Who Qualify for Medicaid or CHIP but Are Not Enrolled. Chapel Hill, NC: North Carolina Rural Health Research and Policy Analysis Center. This brief describes the characteristics of rural and urban children who qualify for Medicaid or CHIP but are not enrolled. Also see the companion brief, Medicaid and CHIP Participation Among Rural and Urban Children (2009).
  
  
• Lawrence RS, Gootman JA, Sim LJ, eds. 2009. Adolescent Health Services: Missing Opportunities. Washington, DC: National Academies Press. This report addresses current adolescent health status and services, improving systems of adolescent health services, preparing a work force to meet adolescents' health needs, and health insurance and access to adolescent health services.
  
  
• Levine PB, Schanzenbach DW. 2009. The Impact of Children's Public Health Insurance Expansions on Educational Outcomes. Cambridge, MA: National Bureau of Economic Research (NBER). This paper examines the impact of public health insurance expansions through Medicaid and CHIP on children's educational outcomes.
  
  
• Levine PB, McKnight R, Heep S. 2009. Public Policy, Health Insurance and the Transition to Adulthood. Cambridge, MA: National Bureau of Economic Research (NBER). This paper assesses the impact of two policies designed to increase insurance coverage for older adolescents and young adults.
  
  
• Napel ST, Bulchis A, Friedenzohn I, McGlynn C. 2010. State of the States 2010: The State We're In. Washington, DC: AcademyHealth. This annual report describes trends in state health care cost and coverage, state eligibility levels for Medicaid and CHIP, state outreach and enrollment efforts for CHIP, state health insurance reform, and state health care delivery system and payment reform.
  
  
• National Adolescent Health Information Center (NAHIC). 2008. Fact Sheet on Health Care Access and Utilization: Adolescents and Young Adults. San Francisco, CA: University of California, San Francisco. This fact sheet contains data on health insurance coverage, preventive and other health services, and unmet health care needs among adolescents and young adults ages 12–24, including those with special health care needs.
  
  
• National Advisory Committee on Rural Health and Human Services. 2009. The 2009 Report to the Secretary: Rural Health and Human Service Issues. Washington, DC: National Advisory Committee on Rural Health and Human Services. This report describes three important issues affecting health and human service delivery in rural communities and recommends solutions. The issues are work force and community development, creating viable patient-centered medical homes in rural areas, and serving children who are at risk.
  
  
• Office of the Inspector General. 2010. Most Medicaid Children in Nine States Are Not Receiving All Required Preventive Screening Services. Washington, DC: Department of Health and Human Services (DHHS). This report describes the extent to which children in nine states received Medicaid Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) screenings. The report also describes state efforts to increase EPSDT-eligible children's participation in EPSDT screenings and the completeness of EPSDT medical screenings.
  
  
• Perry M. 2009. Reducing Enrollee Churning in Medicaid, Child Health Plus, and Family Health Plus: Findings from Eight Focus Groups with Recently Disenrolled Individuals. New York, NY: NYS Health Foundation. This report describes the challenges faced by individuals in recertifying to retain their public health benefits and the problems they face after losing those benefits.
  
  
• Reagin A. 2009. Strengthening Health Care for Children: Primary Care and the Medical Home. Washington, DC: National Business Group on Health. This issue brief examines the role of employers, as purchasers of health benefits, in making changes that will improve the quality of children's health care and expand access to it.
  
  
• Southern Institute on Children and Families. 2009. Medicaid and CHIP Retention: A Key Strategy to Reducing the Uninsured. Columbia, SC: Southern Institute on Children and Families. This report describes Medicaid and CHIP retention issues identified by eight states and effective improvement strategies for improving retention rates.
  
  
• Stebbins H. 2009. Making Maternal and Child Health a Priority. New York, NY: National Center for Children in Poverty. This fact sheet examines state policy choices that promote access to high-quality health care for mothers and children.
  

  

Databases

The databases listed below are excellent tools for identifying data, additional literature and research, and programs about health insurance and access to health care for children and adolescents. Many of the entries below contain tips on how to use the databases efficiently. Please note that databases vary in how terms should be entered; for example, some require quotation marks and others don't. Enter search phrases as shown in bold below.

Data

• ChildStats.gov. Data and reports about children and families, including family and social environment, economic circumstances, health care, physical environment and safety, behavior, education, and health. View statistics about health insurance coverage and source of health care. ChildStats.gov is a service of the Federal Interagency Forum on Child and Family Statistics.
  
  
• Data Resource Center for Child and Adolescent Health (DRC). Data from the National Survey of Children's Health and the National Survey of Children with Special Health Care Needs. View national and state data on over 100 indicators of child health and well-being, including health insurance coverage and access to health care services. DRC is a project of the Child and Adolescent Health Measurement Initiative (CAHMI). View background information about the data-collection mechanism, State and Local Area Integrated Telephone Survey (SLAITS), along with additional data and survey modules.
  
  
• Healthcare Cost and Utilization Project (HCUP): HCUPnet. Data on hospital inpatient and emergency department utilization at the national and state levels, including use of hospitals by children and hospital stays by payer (e.g., Medicaid, private insurance, uninsured). HCUP is an initiative of the Agency for Healthcare Research and Quality (AHRQ).
  
  
• KIDS COUNT Data Center. National and state data to track the status of infants, children, and adolescents in the United States. Data categories include demographics, education, economic well-being, health (includes health insurance coverage), family and community, vital statistics, and indicators by race and ethnicity. KIDS COUNT is a project of the Annie E. Casey Foundation (AECF).
  
  
• Medical Expenditure Panel Survey (MEPS). Data on the cost and use of health care and health insurance coverage from large-scale surveys of families and individuals, their medical providers, and employers across the United States. MEPS is sponsored by the Agency for Healthcare Research and Quality (AHRQ). Recent analyses include
  
  Family Level Expenditures on Health Care and Insurance Premiums Among the Nonelderly Population, 2006. (2009).
  
  Health Insurance Status of Children in America, First Half 1996–2007: Estimates for the U.S. Civilian Noninstitutionalized Population Under Age 18. (2008).
  
  
• National Health Interview Survey. National data on a broad range of health topics including health insurance coverage and access to health care. The survey is sponsored by the National Center for Health Statistics. Recent analyses include
  
  Health Insurance Coverage: Early Release of Estimates from the National Health Interview Survey, January–September 2009. (2010).
  
  NCHS Health Insurance Data. (2009). [Fact sheet].
  
  
• National Quality Measures Clearinghouse™ (NQMC). Evidence-based health care quality measures and measure sets for physicians, hospitals, and health plans to evaluate and improve the quality of health care for consumers. Identify measures on this topic by clicking on Detailed Search and entering insurance, health OR health services accessibility in the Keyword field of the search form. Under Age Range, select the categories for adolescent, child, and infant. Hold down the control key (ctrl) or Apple command key and click your mouse to make multiple selections. Click on Search to get your results. The database is sponsored by the Agency for Healthcare Research and Quality (AHRQ).
  
  
• statehealthfacts.org. State-level data on demographics, health status, health coverage and the uninsured, Medicaid and CHIP, health costs and budgets, Medicare, managed care and health insurance, providers and service use, minority health, women's health, and HIV/AIDS. Information is displayed as bar graphs, tables, or color-coded maps. View individual state profiles or compare data for all states by category. statehealthfacts.org is a project of the Kaiser Family Foundation. Kaiser also offers customizable state Medicaid fact sheets. For detailed information about the Medicaid benefit packages in each state, see Kaiser's Medicaid Benefits Online Database.
  
  
• State Health Access Data Assistance Center (SHADAC): Data Center. Health insurance coverage estimates from the Current Population Survey's Annual Social and Economic Supplement (CPS) and the American Community Survey (ACS). Customize tables of health insurance coverage estimates within a pre-defined set of parameters (i.e., by state or nationally, by year, by age range, and/or by poverty status).
  
  
• Title V Information System (TVIS). Data from annual Title V Block Grant applications and reports submitted by all 59 U.S. states and jurisdictions. To identify information on the topic, conduct several searches. Select Program Data and view data reports in the sections, Individuals Served, Medicaid/Non Medicaid Comparison, and Medicaid and CHIP Eligibility. Also select Measurement and Indicator Data and click on National Performance Measures to select and view data about national goals for providing children and adolescents with health insurance and access to health care in each state. Next, select Measurement and Indicator Data and State Priority Needs Keyword Search. Select the keywords, Access to Health Care and Insurance, from the list (each term must be searched separately). Add Population (e.g., adolescents, children, infants) to the keyword search. The selections, State Performance Measures and State Outcome Measures also provide information about how states are addressing this issue. TVIS is a service of the Maternal and Child Health Bureau (MCHB). Also see MCHB's Discretionary Grant Information System (DGIS).
  
  
• Also see the Catalyst Center chartbook and the data analyses and resources of the Census Bureau.
  

Literature and Research Databases

• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University. Databases to collect, manage, and disseminate knowledge about maternal and child health (MCH), with special emphasis on knowledge gained from initiatives and programs supported by the Maternal and Child Health Bureau (MCHB). The library's bibliographic database is
  
  MCHLine®. Online catalog of materials in the Maternal and Child Health Library with many items about this topic. Selections of recent items are listed in the bibliographies, Children's Health Insurance and Outreach Programs and Strategies. Also, search MCHLine to identify additional materials about access to health care. Conduct two searches in the keyword field of the database search form using the terms "access to health care" child and "access to health care" adolescen. Narrow your searches by adding a publication year or range of years. These searches identify additional items not included in the bibliography.
  
  Also see the MCH Organizations Database and the MCH Projects Database.
  
  
• PubMed. Over 19 million citations for biomedical articles from MEDLINE and life science journals. Citations may include links to full-text articles from PubMed Central or publisher Web sites. To identify citations on the topic, enter the phrase insurance, health OR health services accessibility in the search box. Click on Limits and make the following selections on the page: select a date (e.g. Published in the last 2 years); click on Languages: English; click on Ages: All Child; and select Search Field Tags: MeSH Major Topic. Click on Search to get your results. To narrow your search further or for additional searches, use the MeSH (Medical Subject Headings) database to identify terms (e.g., Medicaid, medically uninsured). PubMed is a service of the National Library of Medicine (NLM).
  

Programs Databases

• Community Pediatrics Grants Database. Archive of community pediatrics grant projects. Identify projects by selecting a topic (e.g., Access/Barriers to Health Care, SCHIP Outreach). The database is a service of the American Academy of Pediatrics (AAP).
  
  
• Discretionary Grant Information System (DGIS). Information about more than 900 grants issued by the Maternal and Child Health Bureau (MCHB). To identify grant information on the topic, select Abstracts and click on Advanced Search. Enter keywords, such as access to health care, insurance, Medicaid (each term must be searched separately and there will be some overlap in search results). Refine your searches by adding information to the other categories on the search form. Click on Search to get your results. To find products and publications produced by MCHB training grantees, select Program Data; select Training; select Search Products and Publications; and select Advanced Search. Enter keywords, such as access to health care, insurance, Medicaid (each term must be searched separately and there will be some overlap in search results). Select a type of publication or publication year(s) to narrow your search. Click on Search to get your results.
  
  
• First Focus: ChildrensBudget.org. Annual funding information for each federally supported program that benefits children. For information about health programs, go to the box, Search Programs. Under Policy Area/Category, select Health. Click on Search Programs.
  
  
• Health Services Research Projects in Progress (HSRProj). Information about ongoing health services research and public health projects. To identify projects on the topic, click on Advanced Search. Enter the search phrase (child OR adolescent) AND (insurance, health OR health services accessibility). Select project date ranges, project status, and/or a state to narrow your search. Click on Search to get your results. Try other search terms, such as Medicaid or medically uninsured. HSRProj is funded by the National Library of Medicine (NLM).
  
  
• Maternal and Child Health Library at the National Center for Education in Maternal and Child Health (NCEMCH), Georgetown University.
  
  MCH Organizations Database. Information about more than 2,000 government, professional, and voluntary organizations involved in MCH activities, primarily at a national level. Find organizations focusing on the topic by conducting two separate searches in the database using the terms "health insurance" and "access to health care" in the keyword field of the database search form. There will be some overlap in the records identified in these searches.
  
  MCH Projects Database. Online catalog of projects funded by the Maternal and Child Health Bureau (MCHB) through October 1, 2002. To identify projects about child health insurance and access to health care, conduct three searches using the terms "health insurance", "access to health care", and "healthy tomorrows" in the abstract field of the database search form. There will be some overlap in the records identified in these searches. Also see MCHB's Discretionary Grant Information System (DGIS) and the Healthy Tomorrows projects, which focus on linking together the resources that children need to access health services.
  
  
• Medicaid Benefits Online Database. Information about benefits covered, populations served, and the limitations, co-payments, and reimbursement policies that apply to Medicaid benefits for all 50 states, the District of Columbia, and U.S. territories. This database is a service of the Kaiser Family Foundation (KFF).
  
  
• State Coverage Initiatives (SCI): Coverage By State. Click on a state to find out about the state's health coverage programs and coverage strategies.
  

  

News and Commentary

• Center for Children and Families: Say Ahhh! A Children's Health Policy Blog. This blog focuses on expanding affordable health insurance coverage options for children and families. The left sidebar lists other health policy blogs.
  
  
• Commonwealth Fund: Newsletters. This collection of newsletters addresses health reform, health care quality, state health policy, federal health policy, and newly released Commonwealth Fund resources. The Commonwealth Fund Blog presents analysis and commentary about health reform and other pressing health policy issues.
  
  
• Families USA: State Health Beat. This electronic newsletter reports on the activities of state health care advocates. The Stand Up for Health Care blog offers analysis and commentary about health reform, children's health, Medicaid, and other health policy topics. Also sign up for the Health Action Network for e-mail updates with information and action steps on Medicaid, Medicare, children's health, private insurance, and other important health care developments.
  
  
• Kaiser Health News. Coverage of health policy issues and developments at the federal and state levels and trends in the delivery of health care and in the marketplace. Presents daily summaries of major health care news from across the nation, as well as original videos and a broad range of commentary on topics that include health reform, Medicaid, and the uninsured.
  

  

Resources for Professionals: Special Topics

Health Reform

This is a selection of the many health reform resources available electronically. This collection includes several Web sites that address health reform measures related to children and adolescents and several Web sites that provide coverage and analysis of federal and state health reform activities. Many of the Web sites listed in the General Resources for Professionals section also address health reform as noted in the Web site description for each.

• American Academy of Pediatrics (AAP): Health Care Reform. Fact sheets, press releases, and testimony about implementing the health reform law to provide the best possible outcomes for children and the pediatricians who care for them.
  
  
• Association of Maternal and Child Health Programs (AMCHP): Health Reform Resources. Summary of MCH-related provisions in the federal health reform bills and links to health reform implementation timelines, summaries, and fact sheets.
  
  
• Catalyst Center: Improving Financing of Care for Children and Youth with Special Health Care Needs.
  
  Health Care Reform and Children and Youth with Special Health Care Needs: Coverage Is Not Enough. (2009). [Issue brief].
  
  What Do Children with Special Health Care Needs Require from Health Care Reform? (2009). [Issue brief].
  
  
• Center for Children and Families (CCF): Health Care Reform. Fact sheets, issue briefs, and a blog about health reform activities as they relate to children and their families. Also offers health reform implementation resources for states. Resources include
  
  Summary of Medicaid, CHIP, and Low-Income Provisions in Health Care Reform. (March 2010). [Fact sheet].
  
  
• Childrens Defense Fund (CDF): Protect Children in Health Reform. Fact sheets, talking points, articles, and a series of short videos aimed at engaging the public about the importance of children's health coverage. Includes health reform legislative updates and a set of fact sheets about children's health coverage in each state including data on the uninsured, those enrolled in Medicaid and CHIP, income eligibility, and enrollment procedures. Materials include
  
  Who Are the Uninsured Children, 2008: Profile of America's Uninsured Children. (2009). [Fact sheet].
  
  
• Commonwealth Fund: Health Reform Resources. Reports, charts, Webinars, podcasts, a newsletter, and a blog on health reform topics that include health system reform, expanding access, payment reform, and quality improvement efforts.
  
  
• Democratic Policy Committee: The Patient Protection and Affordable Care Act and the Health Care and Education Reconciliation Act. Full text of each act, summaries of selected sections, background reports, section-by-section analyses, benefits, provisions on selected topics, health reform for selected population groups, including children and families, and other documents.
  
  
• First Focus: Making Children and Families the Priority. Reports, public opinion research, and advocacy tools about protecting the needs of children in national health reform. First Focus is a bipartisan advocacy organization that is committed to making children and families a priority in federal policy and budget decisions. Also see ChildrensBudget.org.
  
  
• Kaiser Family Foundation (KFF): Health Reform. Issue briefs and in-depth analysis, data, testimony, public opinion polls, news headlines, and multimedia tools about health reform. Includes fact sheets, reports, and interactive maps that describe state health reform initiatives. Also see Kaiser Health News and the KaiserEDU.org collection of online tutorials and resources for faculty and students about health reform.
  
  
• Fox HB, McManus MA. 2009. Health Reform and Adolescents. Washington, DC: National Alliance to Advance Adolescent Health. This issue brief examines the health care needs of adolescents and the financing and delivery system shortcomings that affect their access to appropriate care. The brief urges Congress to consider coverage expansions under Medicaid and CHIP, benefit and payment improvements, grant programs to support interdisciplinary models of primary care, and funds to improve training for adolescent health providers.
  
  
• Also see the Alliance for Health Reform and its issue brief, Future of Children's Health Coverage (2010).
  

  

Outreach and Enrollment

• Center for Children and Families (CCF): State Resource Center. Outreach and enrollment tools, strategies, research, and examples for states. Recent publications include
  
  Express Lane Eligibility: New Options Under CHIPRA. (2010). [Issue brief].
  
  Improving Enrollment and Retention in Medicaid and CHIP: Federal Options for a Changing Landscape. (2009). [Report].
  
  
• Center on Budget and Policy Priorities (CBPP): Start Healthy, Stay Healthy Campaign. Information about and materials for this national outreach effort to identify children and adolescents from working families with low incomes who may be eligible for free or low-cost health insurance programs. The campaign also promotes coordination between state child health programs and Medicaid to ensure that children and adolescents are not in danger of being left without coverage. View CBPP's links to state Medicaid and CHIP applications and tables on state eligibility rules, enrollment and renewal procedures, and cost-sharing practices in Medicaid and CHIP.
  
  
• Children's Partnership: E-Enrollment and Express Lane Eligibility. Information for and about state Medicaid and CHIP programs that streamline enrollment and automate renewal. Includes an implementation toolkit, reports, presentations, fact sheets, forms and other administrative documents, and a newsletter.
  
  
• Insure Kids Now: Outreach and Enrollment. Information about grants for outreach, enrollment, and retention; Webinars about outreach; and an outreach toolkit. Recent resources include
  
  CHIPRA One Year Later: Connecting Kids to Coverage. (2010). [Report].
  
  National Children's Health Insurance Summit: Strategies for Increasing Enrollment and Retention. (2009). [Video clips, PowerPoint presentations, Transcripts].
  
  Summary of Focus Group Research on Children's Health Insurance Programs. (2009). [Report].
  
  
• Kaiser Family Foundation (KFF).
  
  Building an Express Lane Eligibility Initiative: A Roadmap of Key Decisions for States. (2010). [Issue brief].
  
  CHIP Enrollment: June 2008 Data Snapshot. (2009). [Report].
  
  Express Lane Eligibility Efforts: Lessons Learned from Early State Cross-Program Enrollment Initiatives. (2009). [Issue brief].
  
  Medicaid Enrollment in the 50 States: December 2008 Data Update. (2010). [Report].
  
  Why Express Lane Eligibility Makes Sense for States and Low-Income Families. (2009). [Issue brief].
  
  
• National Academy for State Health Policy (NASHP): Maximizing Enrollment for Kids. Information about this program to increase enrollment and retention of eligible children into Medicaid and CHIP programs and to establish and promote best practices among states. A selection of recent resources includes
  
  Maximizing Enrollment for Kids: Results from a Diagnostic Assessment of Enrollment and Retention in Eight States. (2010). [Report]. View separate reports for each of the eight states.
  
  Maximizing Kids' Enrollment in Medicaid and SCHIP: What Works in Reaching, Enrolling and Retaining Eligible Children. (2009). [Report].
  
  
• Robert Wood Johnson Foundation (RWJF): Cover the Uninsured. Background information, fact sheets, data, and research reports for policymakers, advocates, and the media about who is uninsured in the United States, the consequences, and the cost to the nation. Includes health insurance coverage and income data, personal stories, advocacy materials and event information, and consumer guides to finding health insurance in each state. Some information is available in Spanish.
  
  
• Urban Institute (UI): Health Policy Center.
  
  Express Lane Eligibility and Beyond: How Automated Enrollment Can Help Eligible Children Receive Medicaid and CHIP. (2009). [Report].
  
  Nine in Ten: Using the Tax System to Enroll Eligible, Uninsured Children into Medicaid and SCHIP. (2009). [Report].
  
  Progress Enrolling Children in Medicaid/CHIP: Who Is Left and What Are the Prospects for Covering More Children? (rev. ed.). (2009). [Policy brief].
  
  Public Coverage Versus No Coverage for Children: Perceptions and Experiences. (2009). [Report].
  
  
• Brellochs C, King KF, Vanneman M, Lief A, Fryer GF, Aguayo S, Cadogan M, Platt R, Barbot O. 2009. The Access to Coverage and Care Project: An Analysis of Health Insurance Enrollment and Retention and Students in Selected NYC Public Schools. New York, NY: New York City Human Resources Administration. This report focuses on a demonstration project to address how to both decrease the number of uninsured children in New York City and improve continuity of coverage for those already enrolled in public insurance.
  
  
• Cousineau MR, Stevens GD, Farias AJ. 2009. Trends in Child Enrollment in California's Public Health Insurance Programs. Minneapolis, MN: State Health Access Data Assistance Center (SHADAC). This issue brief examines the effectiveness of outreach and enrollment strategies used in California to expand enrollment and retain participants.
  
  
• Hoag S, Uzoigwe C. 2008. Improving Public Coverage for Children: Lessons From CKF in Washington. Princeton, NJ: Robert Wood Johnson Foundation. This issue brief describes the work and lessons learned from the Covering Kids and Families (CKF) project in Washington to increase enrollment and retention in Medicaid and SCHIP.
  
  
• Idala D, Roddy T, Milligan C, Sommers A, Boddie-Willis C, Clark A, Dorn S. 2009. Using Information from Income Tax Forms to Target Medicaid and CHIP Outreach: Preliminary Results of the Maryland Kids First Act. Minneapolis, MN: State Health Access Data Assistance Center (SHADAC). This issue brief documents Maryland's early experience using tax information to identify children who are Medicaid/CHIP eligible. Also see SHADAC's Webinar, Using Income Tax Information to Target Medicaid and CHIP Outreach. (2010). [Webinar].
  
  
• Rosenbaum S. 2008. Medicaid Portability in the Context of Oral Health Care for Head Start–Enrolled Children in Migrant Farmworker Families. Washington, DC: School of Public Health and Health Services, George Washington University. This analysis examines opportunities and challenges in addressing Medicaid eligibility and enrollment for children in Migrant and Seasonal Head Start programs.
  
  
• Santoro K, Murphy B, Pirani H. 2009. Increasing Access to Health Insurance for Children and Families: Innovative Health Plan Outreach and Enrollment Efforts. Washington, DC: National Institute for Health Care Management Research and Educational Foundation. This issue brief examines health plan efforts to increase enrollment in Medicaid and CHIP as well as to create and market affordable private insurance coverage options.
  
  
• Also see the Family USA issue brief, Covering More Children, Rewarding Success: State Performance Bonuses (2009), the AcademyHealth report, State of the States 2010: The State We're In (2010), and the MCH Library bibliography, Outreach Programs and Strategies.
  

  

School-Based and School-Linked Care

• Grantmakers in Health. 2009. School-Based Health Centers: Enabling Health Care Access for Children and Youth "Where They Are." Washington, DC: Grantmakers in Health. This issue brief describes the structure, benefits, financing, and challenges of school-based health centers.
  
  
• Grossman JB, Vang ZM. 2009. The Case for School-Based Integration of Services: Changing the Ways Students, Families and Communities Engage with Their Schools. Philadelphia, PA: Public/Private Ventures. This paper summarizes complementary learning theory and how it provides for integrating school-based health services; reviews current knowledge about the impacts of school-based health services, out-of-school time activity opportunities, and family supports; highlights how these services can affect learning, school connectedness, and access to needed services; and highlights the benefits of offering such services through a highly integrated model.
  
  
• See the MCH Library resource brief, School Health. Also see the School-Based and School-Linked Care section of the knowledge path, Oral Health for Infants, Children, Adolescents, and Pregnant Women.
  

  

Related Knowledge Paths

• Children and Youth with Special Health Care Needs. Resources about health insurance and access to care for children and adolescents with special health care needs.
  
  
• Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) Services in Medicaid. Resources about the provision of EPSDT services under Medicaid.
  
  
• Emotional, Behavioral, and Mental Health Challenges in Children and Adolescents. Resources about accessing and financing mental health services.
  
  
• Oral Health for Infants, Children, Adolescents, and Pregnant Women. Resources about accessing and financing oral health care.
  
  
• Racial and Ethnic Disparities in Health. Resources about disparities in health care access.
  

  

Resources for Families

• See the Maternal and Child Health Library's family resource brief, Health Insurance and Access to Care for Kids and Teens.
  

  

Health Insurance and Access to Care for Children and Adolescents: Knowledge Path, 6th ed. (June 2010). (Updated: July 2010).
Author: Susan Brune Lorenzo, M.L.S., Maternal and Child Health Library.
Reviewers: Beth Dworetzky, M.S., Massachusetts Family Voices and Massachusetts Family-to-Family Health Information Center; Rochelle Mayer, Ed.D., National Center for Education in Maternal and Child Health; Margaret McManus, M.H.S., National Alliance to Advance Adolescent Health.