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Medicaid Disenrollment Patterns Among Children Coming into Contact with Child Welfare Agencies

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Abstract

Objectives To examine retention of Medicaid coverage over time for children in the child welfare system. Methods We linked a national survey of children with histories of abuse and neglect to their Medicaid claims files from 36 states, and followed these children over a 4 year period. We estimated a Cox proportional hazards model on time to first disenrollment from Medicaid. Results Half of our sample (50 %) retained Medicaid coverage across 4 years of follow up. Most disenrollments occurred in year 4. Being 3–5 years of age and rural residence were associated with increased hazard of insurance loss. Fee-for-service Medicaid and other non-managed insurance arrangements were associated with a lower hazard of insurance loss. Conclusions for Practice A considerable number of children entering child environments seem to retain Medicaid coverage over multiple years. Finding ways to promote entry of child welfare-involved children into health insurance coverage will be critical to assure services for this highly vulnerable population.

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Acknowledgments

This study was funded by the National Institute of Mental Health (NIMH) (R01 MH092312, and T32 MH019960), the NIMH Office for Research in Disparities and Global Mental Health (HHSN271201200644P), and the Agency for Healthcare Research and Quality (R01 HS020269). The National Survey of Child and Adolescent Well-Being (NSCAW) was developed under contract with the Administration on Children, Youth, and Families, US Department of Health and Human Services (ACYF/DHHS). The data have been provided by the National Data Archive on Child Abuse and Neglect. The information and opinions expressed herein reflect solely the position of the authors. Nothing herein should be construed to indicate the support or endorsement of its content by ACYF/DHHS, NIMH, or the National Institutes of Health.

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Authors and Affiliations

  1. School of Social Work, Rutgers, The State University of New Jersey, 536 George Street, New Brunswick, NJ, 08901, USA

    Ramesh Raghavan

  2. RTI International, Research Triangle Park, NC, 27709, USA

    Benjamin T. Allaire

  3. Brown School, Washington University in St. Louis, Campus Box 1196, St. Louis, MO, 63130, USA

    Derek S. Brown & Raven E. Ross

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  1. Ramesh Raghavan
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Correspondence to Ramesh Raghavan.

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Raghavan, R., Allaire, B.T., Brown, D.S. et al. Medicaid Disenrollment Patterns Among Children Coming into Contact with Child Welfare Agencies. Matern Child Health J 20, 1280–1287 (2016). https://doi.org/10.1007/s10995-016-1929-9

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