Insurance coverage during transitions: Evidence from Medicaid automatic enrollment for children receiving supplemental security income

Objectives To analyze relationships between Medicaid automatic enrollment for child Supplemental Security Income (SSI) recipients and health insurance coverage during transitions. Data Sources and Study Setting Medical Expenditure Panel Study, 2000–2020 and National Survey for Children with Special...

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Bibliographic Details
Published in:Health services research 2024-06, Vol.59 (3), p.e14261-n/a
Main Authors: Rennane, Stephanie, Sobol, Danielle, Stein, Bradley D., Dick, Andrew
Format: Article
Language:English
Subjects:
Access control
Adolescent
Analysis
Automatic
automatic enrollment
Child
Child, Preschool
Children
children with special health care needs
Company systems management
Data collection
Demographic aspects
Disability
Disability allowances
Disabled Children - statistics & numerical data
disabled persons
Eligibility Determination
Enrollments
Female
Forecasts and trends
Government programs
Health care expenditures
Health care policy
Health care reform
Health insurance
Health insurance industry
Health planning
Humans
Infant
Information management
Insurance
Insurance coverage
Insurance Coverage - statistics & numerical data
Insurance, Health - statistics & numerical data
Male
Market trend/market analysis
Medicaid
Medicaid - statistics & numerical data
Medicare and Medicaid
Persons
Polls & surveys
Regression models
Research Brief
Security
Services
Special needs children
Statistical analysis
Supplemental Security Income
Surveys
United States
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Description
Summary:Objectives To analyze relationships between Medicaid automatic enrollment for child Supplemental Security Income (SSI) recipients and health insurance coverage during transitions. Data Sources and Study Setting Medical Expenditure Panel Study, 2000–2020 and National Survey for Children with Special Health Care Needs, 2001–2010. Study Design Leveraging variation in SSI‐Medicaid automatic enrollment status across regions and over time, we estimate a regression model to quantify associations between automatic enrollment and insurance coverage. We validate our findings in the NS‐CSHCN. Data Collection Our sample includes children receiving SSI for a disability. We also analyze a subsample of children newly enrolled in SSI. Principal Findings Automatic enrollment is associated with a statistically significant increase in insurance coverage. Expanding automatic enrollment to all states is associated with increases in Medicaid enrollment of 3% (CI 0.9%–6.7%) among all SSI children and 7% (CI 1.1%–13.9%) among children newly enrolled in SSI. We find similar decreases in uninsurance. Analysis in the NS‐CSHCN replicates these findings. Conclusions Medicaid automatic enrollment policies are associated with increased insurance coverage for SSI children, particularly those transitioning into the program. Medicaid policy defaults could play an important role in reducing administrative burdens to improve children's coverage and access to care.
ISSN:0017-9124
1475-6773
DOI:10.1111/1475-6773.14261