A profile of the population enrolled in New York State's Child Health Plus

Background. The recently enacted State Children's Health Insurance Program (SCHIP), designed to provide affordable health insurance for uninsured chil dren, was modeled in part on New York State's Child Health Plus (CHPlus), w hich was implemented in 1991. All SCHIP programs involve voluntary enrollme nt of eligible children. Little is known about characteristics of children who enroll in these programs. Objectives. To provide a profile of children enrolled in CHPlus between 199 3 and 1994 in the 6-county upstate New York study area, and to estimate the participation rate in CHPlus. Methods. A parent interview was conducted to obtain information about child ren, 0 to 6.9 years old, who enrolled in CHPlus in the study area. Two scho ol-based surveys and the Current Population Survey were used to estimate he alth insurance coverage. Enrollment data from New York State's Department o f Health, together with estimates of the uninsured, were used to estimate p articipation rates in CHPlus. Results. Most children enrolled in CHPlus in the study area were white. Alt hough 17% of all children in the study area who were <13 years old and livi ng in families with incomes below 160% of the federal poverty level were bl ack, only 9% of CHPlus-enrolled children were black. Twenty-one percent of enrolled children were uninsured during the entire year before enrollment a nd 61% of children had a gap in coverage lasting >1 month. Children were ge nerally healthy; only 4% had fair or poor health. Eighty-eight percent of p arents of enrolled children had completed high school or a higher level of education. Parents reported that loss of a job was the main reason for loss of prior health insurance for their child. Most families learned about CHP lus from a friend (30%) or from their doctor (26%). The uninsured rate amon g children in the study area was approximately 4.1%. By 1993, the participa tion rate in CHPlus was about 36%. Conclusion. Blacks were underrepresented in CHPlus. Because the underlying uninsured rate was relatively low and parental education and family income were relatively high, the effects of CHPlus observed in this evaluation may be conservative in comparison to the potential effects of CHPlus for other populations of children. Participation rates during the early years of the program were modest.