NCPA - National Center for Policy Analysis

Survey: Parents Don't Want or Need S-Chip

August 6, 2001

The Urban Institute has two new reports on problems in the State Children's Health Insurance Program (S-CHIP). According to researchers, "public health insurance programs have the potential to reach 80 percent of uninsured children, yet many eligible children still lack coverage."

This has been an issue ever since the program began. Policy-makers assumed that people would rush to enroll their kids. When that didn't happen they assumed it was because people hadn't heard of the program and they invested many millions of dollars into "outreach" programs, including printing information on pizza boxes. But still, few parents have enrolled their kids.

To find out why, the Urban Institute surveyed 2,485 low-income families and found that 88 percent had heard of S-CHIP and Medicaid, but 76 percent of those never inquired about the program.

  • Of those who had heard of the program but had not inquired about it, a plurality (40 percent) said they "did not need or want the program."
  • Some 30 percent said they didn't think their child was eligible and 14 percent thought there was too much administrative hassle involved.
  • Of those who said they didn't want the program, 96.8 percent said they were in excellent or good health.

And there is the rub, says health policy expert Greg Scandlen, editor of NCPA's Health Policy Week. In a "guaranteed issue" environment where you cannot be turned down for coverage and you know you can quickly get coverage when a need arises, why bother enrolling ahead of time? It may frustrate policy makers who want to be able to count enrolled noses, but it makes perfect sense to real people living real lives.

Source: Genevieve Kenney and Jennifer Haley, "Why Aren't More Uninsured Children Enrolled in Medicaid or SCHIP?" Series B, No. B-35, May 2001, and Genevieve Kenney, Jennifer Haley and Lisa Dubay, "How Familiar Are Low-Income Parents with Medicaid and SCHIP?" Series B, No. B-34, May 20, 2001, both New Federalism National Survey of America's Families, Urban Institute, 2100 M Street, N.W., Washington, D.C. 20037, (202) 833-7200.

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