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Public Coverage Versus No Coverage for Children: Perceptions and Experiences of Parents in Four Cities

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Abstract:

The Covering Kids & Families® (CKF) initiative of the Robert Wood Johnson Foundation (RWJF) had two goals: to increase the enrollment of uninsured, eligible children and adults in Medicaid or State Children’s Health Insurance Program (SCHIP), and to build the knowledge, experience, and capacity necessary to sustain the enrollment and retention of children and adults in those programs after the CKF program ends (Grant and Ravenell, 2002).

In this report, the evaluation team sought to confirm findings of a 2005 focus group suggesting that satisfaction with safety-net providers when their children were uninsured might reduce parents’ motivation to enroll their children in public coverage, particularly if their children are healthy, and to gain a better understanding of the perceptions shaping enrollment decisions of parents whose children are uninsured. To do so, the evaluation team conducted individual interviews with low-income parents in four cities.

The findings from these interviews do not support the hypothesis that parental concerns about access to and quality of care under Medicaid and SCHIP reduce enrollment of eligible children in these programs. The positive feedback on the programs from parents whose children were enrolled—and the strong desire of almost all parents of uninsured children to enroll their children—attest to the success that states have had in publicizing their public health insurance programs and addressing prevalent concerns associated with them. However, the administrative barriers faced by parents often serve as a deterrent to enrollment and renewal.