Published online November 1, 2007
PEDIATRICS Vol. 120 No. 5 November 2007, pp. e1217-e1224 (doi:10.1542/peds.2007-0092)
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ARTICLE

Is There Differential Retention of Children With Special Health Care Needs in the State Children's Health Insurance Program?

Tamarie Macon, BSa, Jane E. Miller, PhDa,b, Dorothy Gaboda, PhDc, Theresa Simpson, BSc and Joel C. Cantor, ScDb,c

a Institute for Health, Health Care Policy, and Aging Research
b E.J. Bloustein School of Planning and Public Policy
c Center for State Health Policy, Rutgers University, New Brunswick, New Jersey

OBJECTIVE. The purpose of this work was to determine whether children with special health care needs in New Jersey's State Children's Health Insurance Program are less likely to become uninsured than children without special health care needs.

PATIENTS AND METHODS. We used the 2003 New Jersey FamilyCare Supplement to the New Jersey Family Health Survey. Children were randomly selected from the universe of children enrolled in New Jersey FamilyCare as of May 2002, and their families were surveyed during 2003 (N = 675). The Children With Special Health Care Needs Screener was used to identify 5 types of special health care needs. We estimated multinomial logistic regression models of final enrollment status according to the presence of ≥1 special health care need, controlling for demographic characteristics.

RESULTS. Roughly 1 of every 5 children in New Jersey FamilyCare had ≥1 special health care need. Older children and boys had greater odds of having special health care needs than others. Children with special health care needs had only one fourth the odds of becoming disenrolled and uninsured compared with children without special health care needs, even when controlling for age, gender, race/ethnicity, and insurance plan level. There was no difference in likelihood of finding other health insurance according to children with special health care needs status.

CONCLUSIONS. Children with special health care needs were more likely than children without such needs to be covered by health insurance at the time of the survey, either by retaining State Children's Health Insurance Program coverage or by finding other insurance. The higher retention of children with special health care needs in New Jersey FamilyCare is good news for families of these children and their advocates. However, higher health care costs for these children should be considered in federal and state budget planning for the State Children's Health Insurance Program.

Key Words: children with special health care needs • chronic health conditions • health insurance • State Children's Health Insurance Program • uninsured

Abbreviations: SCHIP—State Children's Health Insurance Program • CSHCN—children with special health care needs • SHCN—special health care need • NJFCS—New Jersey FamilyCare Supplement • NJFC—New Jersey FamilyCare • FPL—federal poverty level • OR—odds ratio • CI—confidence interval

Accepted Apr 27, 2007.