How health policy influences quality of care in pediatrics

Public health insurance in Oregon: underenrollment of eligible children and parental confusion about children's enrollment status

OBJECTIVES

We identified characteristics of Oregon children who were eligible for the Oregon Health Plan (OHP), the state's combined Medicaid-Children's Health Insurance Program (CHIP), but were not enrolled in January 2005. We also assessed whether parents' confusion regarding their children's status affected nonenrollment.

METHODS

We conducted cross-sectional analyses of linked statewide Food Stamp Program and OHP administrative databases (n = 10 175) and primary data from a statewide survey (n = 2681).

RESULTS

More than 20% of parents with children not administratively enrolled in OHP reported that their children were enrolled. Parents of 11.3% of children who were administratively enrolled reported that they were not. Eligible but unenrolled children had higher odds of being older, having higher family incomes, and having employed and uninsured parents.

CONCLUSIONS

These findings reveal an important discrepancy between administrative data and parent-reported access to public health insurance. This discrepancy may stem from transient coverage or confusion among parents and may result in underutilization of health insurance for eligible children.