MCH Best. NPM 15: Continuous and Adequate Insurance
Strategy. Expansion of Coverage Eligibility
Approach. Promote expansion of Medicaid benefit eligibility through support of Medicaid buy-in policy.
Overview. Children who reside in states that expanded public health insurance programs to parents participate in Medicaid at a rate that is 20 percentage points higher than of those who live in states with no expansions.1,2
Evidence. Moderate Evidence. Medicaid buy-in programs have shown to be effective. This strategy has been tested more than once and results trend positive overall. Access the peer-reviewed evidence through the MCH Digital Library. (Read more about understanding evidence ratings).
Target Audience. State/National.
Outcome. Percent of children ages 0-17 who are adequately insured. For detailed outcomes related to each study supporting this strategy, click on the peer-reviewed evidence link above and read the "Intervention Results" for each study.
Examples from the Field. There are currently 2 ESMs across all states/jurisdictions that use this strategy directly or intervention components that align with this strategy. Access descriptions of these ESMs through the MCH Digital Library. You can use these ESMs to see how other Title V agencies are addressing the NPM.
Sample ESMs. Using the approach “Promote expansion of Medicaid benefit eligibility through support of Medicaid buy-in policy,” here are sample ESMs you can use as a model for your own measures using the Results-Based Accountability framework (for suggestions on how to develop programs to support this strategy, see The Role of Title V in Adapting Strategies):
Note. ESMs become stronger as they move from measuring quantity to measuring quality (moving from Quadrants 1 and 3, respectively, to Quadrants 2 and 4) and from measuring effort to measuring effect (moving from Quadrants 1 and 2, respectively, to Quadrants 3 and 4):
1Hudson, J. L., & Moriya, A. S. (2017). Medicaid expansion for adults had measurable ‘welcome mat’ effects on their children. Health Affairs, 36(9), 1643-1651.
2 Dubay & Kenney. (2003). Expanding Public Health Insurance to Parents: Effects on Children’s Coverage Under Medicaid. Heath Services Research.