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Med Care Res Rev. 2011 Feb;68(1):56-74. doi: 10.1177/1077558710374620. Epub 2010 Jul 30.

Impact of Medicaid/ SCHIP disenrollment on health care utilization and expenditures among children: a longitudinal analysis.

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HealthCore, Inc., Wilmington, DE 19801, USA.


This study examines the impact of disenrolling from Medicaid/State Children's Health Insurance Programs (SCHIP) on health care utilization and expenditures among children using the 1996-2005 Medical Expenditure Panel Survey data. Changes in expenditures and utilization upon Medicaid/SCHIP disenrollment were examined for two disenrollment groups, children who became uninsured and those who transitioned to private insurance; relative to a control group, those continuously enrolled in Medicaid/SCHIP during the study period. In multivariate analysis, a modified two-part model and difference-in-difference analytic approach were used. The dependent variables were changes in total expenditures and changes in utilization (i.e., well-child visits, physician visits, emergency room visits, hospitalizations, and prescription drug use) from pre- to post-disenrollment round. This study found that losing Medicaid/SCHIP coverage is associated with decreased preventive care utilization among children, regardless of the insurance status post-disenrollment. In addition, children who become uninsured following Medicaid/SCHIP disenrollment may also experience reductions in physician visits and prescription drug use.

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