The Effect of a Health Care Visit on Transitions to Medicaid or SCHIP among Uninsured Low - Income Children

Despite major efforts to expand public program eligibility to uninsured children, many low-income children remain unenrolled. Some have argued that we should not be as concerned about these eligible, uninsured children because they can and will be become enrolled with they get sick and present for a health care visit. This study addresses the question of whether uninsured low-income children do in fact become insured when they are brought in for care. It uses longitudinal data from two panels of the Medical Expenditure Panel Survey (MEPS) to model the effect of a health care visit on transitions from uninsured to insured among low-income children. An instrumental variable approach, using data on sibling accidents, is employed to overcome problems associated with the endogenous relationship between visits and enrollment. Results suggest that many low-income uninsured children are not becoming enrolled after a health care visit. Outreach efforts such be bolstered and strengthened to address barriers that keep parents from enrolling their children in public coverage.