Increase In Federal Match Associated With Significant Gains In Coverage For Children Through Medicaid And CHIP
Increase In Federal Match Associated With Significant Gains In Coverage For Children Through Medicaid And CHIP
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DOI：
10.1377/hlthaff.2011.0988
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发表时间：
2012-08-01
期刊：
影响因子：
9.7
通讯作者：
Davis, Matthew M.
中科院分区：
文献类型：
--
作者：
Patrick, Stephen W.;Choi, Hwajung;Davis, Matthew M.
随着过去十年生活贫困儿童数量的稳步增加，医疗补助和儿童健康保险计划 (CHIP) 又招募了数百万青少年。联邦和州政府共同资助这两个计划，联邦部分由联邦医疗援助百分比决定，通常称为“联邦匹配”。联邦政府利用间歇性增加联邦补贴的方式，在经济低迷时期向各州提供财政救济。最近一次大幅增长于 2011 年 6 月结束，但对儿童医疗补助和 CHIP 入学率的确切影响尚不清楚。之前没有研究在其他州因素的背景下评估联邦匹配与儿童参加州医疗补助或 CHIP 计划的关联。为了揭示儿童公共覆盖率随联邦匹配差异的程度而变化，我们检查了 1999 年至 2009 年所有 50 个州的公开数据。我们发现，联邦匹配增加 10 个百分点与医疗补助和 CHIP 入学人数增加 1.9% 相关，相当于大约 500,000 名儿童。在根据多个州级因素（包括生活在贫困中的儿童比例）进行调整后，这种关联仍然存在。该分析强调了联邦配套在支持扩大儿童医疗补助和 CHIP 覆盖范围方面的核心作用。
As the number of children living in poverty has increased steadily over the past decade, Medicaid and the Children's Health Insurance Program (CHIP) have enrolled millions of additional youths. Federal and state governments jointly finance both programs, with the federal portion determined by the Federal Medical Assistance Percentage, commonly known as the "federal match." The federal government has used intermittent increases in the federal match as a way to provide fiscal relief to states during economic downturns. The most recent broad increase ended in June 2011, but the precise impact on Medicaid and CHIP enrollment for children is not known. No previous study has evaluated the association of the federal match with children's enrollment in state Medicaid or CHIP programs in the context of other state factors. To shed light on the degree to which public coverage for children varies with differences in the federal match, we examined publicly available data from all fifty states from 1999 to 2009. We found that a ten-percentage-point increase in the federal match was associated with a 1.9 percent increase in Medicaid and CHIP enrollment, equivalent to approximately 500,000 children. This association persisted when adjusted for multiple state-level factors, including the proportion of children living in poverty. This analysis underscores the central role of the federal match in supporting expansion of Medicaid and CHIP coverage for children.