Medicaid disenrollment patterns among children coming into contact with child welfare agencies
Raghavan, R., Allaire, B., Brown, D., & Ross, R. E. (2016). Medicaid disenrollment patterns among children coming into contact with child welfare agencies. Maternal and Child Health Journal, 20(6), 1280-1287. https://doi.org/10.1007/s10995-016-1929-9
Objectives To examine retention of Medicaid coverage over time for children in the child welfare system. Methods We linked a national survey of children with histories of abuse and neglect to their Medicaid claims files from 36 states, and followed these children over a 4 year period. We estimated a Cox proportional hazards model on time to first disenrollment from Medicaid. Results Half of our sample (50 %) retained Medicaid coverage across 4 years of follow up. Most disenrollments occurred in year 4. Being 3-5 years of age and rural residence were associated with increased hazard of insurance loss. Fee-for-service Medicaid and other non-managed insurance arrangements were associated with a lower hazard of insurance loss. Conclusions for Practice A considerable number of children entering child environments seem to retain Medicaid coverage over multiple years. Finding ways to promote entry of child welfare-involved children into health insurance coverage will be critical to assure services for this highly vulnerable population.