Uninsured Children In The United States



Table of Contents

CHAPTER 3: METHODOLOGY3

Introduction3

Researcher's Philosophy4

Research Design Guide or Model5

Research Design Strategy5

Sampling Design and Setting5

Measures6

Data Collection Procedures6

Bibliography11

CHAPTER 3: METHODOLOGY



Introduction

A growing number of American children do not have health insurance; at any time during the year >11 million children (14%) are uninsured. Despite their lack of insurance, most uninsured children do receive some medical care, which is paid for from a variety of sources. Physicians and hospitals often provide charity care to uninsured patients. Other costs are borne by the families themselves, who pay out-of-pocket, and by other patients who are charged more to compensate for the costs of treating the uninsured. In response to the large number of children without insurance, President Clinton signed into law the State Children's Health Insurance Program (SCHIP), which will provide up to $40 billion through the year 2007 for states to expand health insurance coverage for children.With SCHIP, the government has assumed responsibility for most of the costs of caring for children who are eligible for the program.

In response to the increase in the number of American children without health insurance, new federal and state programs have been established to expand health insurance coverage for children. However, the presence of insurance reduces the price of care for families participating in these programs and stimulates the use of medical services, which leads to an increase in health care costs. In this article, we identified the additional expenditures associated with the provision of health insurance to previously uninsured children.

Researcher's Philosophy

The research will be based on qualitative case study in which New York State implemented the CHPlus program in August 1991. Children <13 years old who were New York State residents having a gross family income below 222% of the federal poverty level and having no equivalent coverage were eligible for CHPlus. Children enrolled in CHPlus received a standard health insurance benefit package that offered coverage for the services of a comprehensive set of primary and specialty clinicians. During the study period, CHPlus only covered outpatient services. Since that time, the New York State legislature has expanded the program both by increasing the eligibility age to children up to 19 years (effective January 1, 1997) and by including coverage for inpatient services consistent with SCHIP guidelines.

Initially CHPlus was financed primarily through the Statewide Bad Debt and Charity Care Pool. Funding began at $20 million annually and has grown steadily; the state contribution is expected to be >$256 million in the 1999 fiscal year. Additionally, New York State can expect to receive approximately $200 million more for CHPlus from the federal block grant program. Insurance premiums paid by some families have been a supplementary source of funds, paid on a sliding scale; the annual premiums are determined by family income. Premiums range from no payment for incomes 166% of the federal poverty level to $100 per family for those with incomes between 166% and 222% percent of the federal poverty level. Children from families whose income exceeded 222% of the federal poverty ...