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Covering Kids & Families Case Study of Missouri Exploring Medicaid and SCHIP Enrollment Trends and Their Links to Policy and Practice

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This report assesses the effectiveness of the Covering Kids & Families (CKF) program that was sponsored by the Robert Wood Johnson Foundation in 46 states with 152 grantees. Its goals were to reduce the number of uninsured children and adults eligible for health coverage, and to sustain those reductions after CKF ended. This analysis focuses on Missouri from 1999 through to 2005. Data were collected from the Medicaid Statistical Information System and obtained from the Centers for Medicare and Medicaid Services.

Key Findings

* Outreach maintained a relatively low profile, taking place mainly at the local level.
* The number of children entering public health insurance programs in Missouri started off exceptionally high in 1999, but declined over time.
* The decline occurred at the same time as a rise in the unemployment rate, which should have increased enrollments.
* The drop was due to the state having to contend with a downturn in the economy, combined with political change.

The experience in Missouri reflects a two-part story showing increases in enrollment for health coverage programs for the first few years of CKF, followed by decreases as state officials faced economic and political challenges.