Oregon provides a unique laboratory to study how CHIP has improved access to health insurance and medical care for low-income children. Oregon has chosen to offer two very different CHIP health insurance options: (1) a Medicaid """"""""look-alike"""""""" program; and (2) a premium subsidy program. Eligibility requirements are identical under both programs (up to 170 percent of FPL). The Medicaid CHIP program is virtually indistinguishable from Oregon's regular Medicaid program. The premium subsidy CHIP program is run by a separate state agency and assists low-income children in buying insurance either through their parent's employer or through the individual market. Unlike the Medicaid CHIP program, however, the premium subsidy program does require some modest cost-sharing. This study will identify the factors leading parents to seek publicly subsidized health insurance, which insurance option they choose, and the cumulative impacts of these decisions on children's access to medical care, with a special emphasis on Hispanic children. The cross-sectional component of this study will consist of a telephone survey of the parents of three groups of children (with an oversample of Hispanic children): children enrolled in the Medicaid look-alike program, children enrolled in the premium subsidy program, and uninsured children. The survey will focus on insurance-seeking behavior, usual source of care, access and utilization, and satisfaction. The longitudinal component will follow children over time using secondary data to examine turn-over in CHIP eligibility. A postcard survey will be conducted of all children who do not re-apply for CHIP coverage when their eligibility period expires. Understanding the perceived benefits and liabilities of the two CHIP options will assist policymakers in making programmatic changes to help increase enrollment. This study will also shed light on whether one of the two CHIP programs is more successful than the other in attracting Hispanic children and securing access to medical care for them.
