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Synthesis of 10 Case Studies: Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice

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Abstract:

During the Covering Kids and FamiliesTM(CKF) evaluation, the study team selected 10 states as case studies to examine the interplay between children's coverage in Medicaid and SCHIP, the state economic and political environment, the state's policy and procedures related to coverage, and the activities of the state's CKF grantees. The case study site visits, which took place between 2005 and 2007, included meetings with state officials, CKF state grantee staff and selected local project staff.

Before the visits, the evaluation team prepared graphs showing trends in new enrollment in SCHIP and Medicaid. During the visits, the team asked state officials and CKF state grantee staff members what they thought were the reasons for certain directions in these trends. Combined with statistical analysis of these trend data, the team used the information provided by interview respondents to identify the factors that had contributed to these changes.

What follows is a brief summary of the overarching findings from the resulting 10 case study reports. Additionally, the findings summarized in this brief provide evidence for links in some states between the CKF grant program and policy changes; the findings also provide substantial evidence across states for links between the policy changes and enrollment.