Is There Adverse Self-Selection of Children with Special Health Care Needs in the State Children’s Health Insurance Program (SCHIP)?

Tamarie Macon, Rutgers University
Jane E. Miller, Rutgers University
Dorothy Gaboda, Rutgers University
Theresa Simpson, Rutgers University
Joel Cantor, Rutgers University

Children with special health care needs (CSHCN) use more health services than other children; hence health insurance is critical for them. We investigated disenrollment patterns for CSHCN and non-CSHCN in New Jersey’s State Children’s Health Insurance Program (NJ FamilyCare). We used the 2003 NJ FamilyCare Supplement to the New Jersey Family Health Survey. Children were randomly selected from those enrolled in NJ FamilyCare as of May 2002 (N=675). We used the CSHCN Screener – a non-categorical approach to identifying children with special health care needs. Twenty-one percent of children in NJ FamilyCare had at least one SHCN. In binary logistic regressions controlling for demographics and SCHIP features, CSHCN were only one-fifth as likely as non-CSHCN to become uninsured. Multinomial logit will be used to compare odds of (a) finding other insurance, (b) becoming uninsured, and (c) retaining SCHIP coverage. CSHCN were far less likely than non-CSHCN to become uninsured.