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Barriers to enrollment in a state child health insurance program
A Kempe1, B L Renfrew, J Barrow
1Department of Pediatrics, University of Colorado Health Sciences Center, Denver, CO, USA. kempe.allison@tchden.org
Objective:
To identify barriers to enrollment into Colorado's Child Health Insurance Plan (CHP+) for non-Hispanic (NH), Hispanic (H), and uninsured families.
Design:
Telephone survey of 1) random samples of families who requested an application but did not complete it (N = 273 NH, N = 159 H) and 2) families with uninsured children identified by random-digit-dial statewide surveys (N = 165).
Results:
Major reasons for not enrolling included 1) got other insurance (NH 16.5%; H 27.2% P <.01), 2) thought household income was too high to qualify (NH 21.0%; H 11.9% P =.01), and 3) paperwork (NH 13.4%; H 14.7%, P = NS). Of those who thought their income was too high (N = 76, 17.6%), 58.5% appeared eligible based on reported income. Of uninsured families, only 41.7% had heard of CHP+. Of those who had never applied, major remediable reasons included not knowing enough about the program (20.9%) and thinking household income was too high (9.3%).
Conclusions:
Effective marketing and education to increase awareness of CHP+ and ensure understanding of eligibility are critical to the success of the program.