THE CHILD HEALTH INSURANCE PROGRAM:
EARLY IMPLEMENATION IN SIX STATES

Prepared by:
Lynne M. Fender, Project Director
Melissa Panagides-Busch
Rhoda Schulzinger
American Institutes for Research

July 1999

Table of Contents

Acknowledgements
 
Chapter I: Introduction and Cross-Case analysis
    Background
    Key Requirements for CHIP
    The Study
    Organization of the Report
  Cross-Case Analysis
    History and Implementation
    History
    Implementation
  Federal/State Financing
  Key Players and Administration
  Outreach
    State Approaches
    A Seamless Health Care System for Children
    Collaboration Among Public and Private Agencies
    Marketing to Hard-to-Reach Populations
    Outreach Funding
    Woodwork Effect
  Crowd-Out Prevention
    Setting the FPL Level
    Waiting Periods
    Cost-Sharing
    Lock-out Periods
    Employer Buy-in
  Data Collection and Evaluation
    Data Used for Program Design
    Data Used for Program Evaluation
    Other Data Collection Methods
  Conclusion
 
Chapter II: CHIP in Alabama
    History and Implementation
    Federal and State Financing
    Current Enrollment
    Key Factors in Alabama’s Implementation
  Outreach
    State Approach
    Key Players and Administration
    Collaboration with Other Agencies and Organizations on Outreach
    Creating a Seamless Health Care System for Eligible Children
    Funding for Outreach
    Marketing to Hard-to-Reach Populations
    Woodwork Effect
    Potential Future Outreach
    Advice for Other States on Outreach
  Crowd-Out Prevention
    State’s Response
    Premiums
    Lock-out Periods
    Co-payments
    Employer Buy-In
  Data Collection and Evaluation
    Program Design Data
    Evaluation Data
    Other Data Collection Methods
  Challenges to Implementation
    Ten Percent Cap on Administrative Expenses
    Web Sites for More Information
     
Chapter III: CHIP in Colorado
    History and Implementation
    Federal/State Financing
    Current Enrollment
    Key Factors for Colorado’s Implementation
  Outreach
    State Approach
    Key Players and Administration
    Collaboration with Other Agencies and Organizations on Outreach
    Creating a Seamless Health Care System for Eligible Children
    Funding for Outreach
    Marketing to Hard-to-Reach Populations
    Woodwork Effect
    Potential Future Outreach
    Advice for Other States
  Crowd-Out Prevention
    State’s Response
    FPL Eligibility Level
    Benefits Package
    Waiting Periods
    Premiums
    Lock-out Periods
    Co-Payments
    Employer Buy-In
  Data Collection and Evaluation
    Data for Program Design
    Data for Program Evaluation
  Challenges to Implementation
    Ten Percent Cap on Administrative Expenses
    Other Challenges
    Web Sites for More Information
     
Chapter IV: CHIP in Massachusetts
History and Implementation
Federal/State Financing
Current Enrollment
Key Factors in Massachusetts Implementation
Outreach
State Approach
Key Players and Administration
Collaboration with Other Agencies and Organizations
Creating a Seamless Health Care System for Eligible Children
Funding for Outreach
Marketing to Hard-to-Reach Populations
Woodwork Effect
Advice for Other States on Outreach
Crowd-Out Prevention
State’s Response
Premiums
Lock-out Periods
Co-payments
Employer Buy-In
Data Collection and Evaluation
Data for Program Design
Data for Program Evaluation
Other Data Collection Methods
Challenges to Implementation
Chapter V: CHIP in New York
History and Implementation
State Compliance with Title XXI
Title XXI
Federal/State Financing
Current Enrollment
Key Factors in New York Implementation
Outreach
State Approach
Key Players and Administration
Title XXI
Collaboration with Other Agencies and Organizations
Creating a Seamless Health Care System for Eligible Children
Funding for Outreach
Marketing to Hard-to-Reach Populations
Woodwork Effect
Advice for Other States on Outreach
Crowd-Out Prevention
State’s Response
Waiting Periods
FPL Eligibility Levels
Premiums
Co-payments
Employer Buy-In
Data Collection/Analysis
Data for Program Design
Data for Program Evaluation
Other Data Collection Methods
Challenges to Implementation
Ten Percent Cap on Administrative Expenses
Other Challenges
Chapter VI: CHIP in Ohio
History and Implementation
Federal/State Financing
Current Enrollment
Key Factors for Ohio’s Implementation
Outreach
State Approach
Key Players and Administration
Collaboration with Other Agencies
Creating a Seamless Health Care System for Eligible Children
Funding for Outreach
Advice for Other States
Crowd-Out Prevention
State’s Response
Employer Buy-In
Data Collection and Evaluation
Data for Program Design
Data for Program Evaluation
Other Data Collection Methods
Web Sites for More Information
Chapter VII: CHIP in Oregon
History and Implementation
Federal/State Financing
Current Enrollment
Key Factors for Oregon’s Implementation
Outreach
State Approach
Key Players and Administration
Collaboration with Other Agencies and Organizations on Outreach
Creating a Seamless Health Care System for Eligible Children
Funding for Outreach
Marketing to Hard-to-Reach Populations
Woodwork Effect
Potential Future Outreach
Advice to Other States
Crowd-Out Prevention
State’s Response
Premiums
Lock-out Periods
Co-payments
Employer Buy-In
Data Collection and Evaluation
Data for Program Design
Data for Evaluation
Challenges to Implementation
Web Sites for More Information