Medicaid and CHIP: Given the Association between Parent and Child Insurance Status, New Expansions May Benefit Families

The 2010 Patient Protection and Affordable Care Act (PPACA) expands health insurance to millions of individuals, including many parents. New insurance options for parents raise a question about whether providing health insurance to parents benefits their children. The Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) asked GAO to assess (1) the extent a parent's health insurance status is associated with a child's health insurance status, use of services, and parental satisfaction with their child's care; and (2) how selected states' parent coverage under Medicaid and CHIP may change given upcoming expansions. To examine the association between a parent's and a child's health insurance status, GAO analyzed data from 3 years of the Medical Expenditure Panel Survey (2005-2007), a nationally representative survey. GAO categorized parent and child health insurance status as private, public, or uninsured, and analyzed nine parent/child insurance combinations. GAO also analyzed relevant, peer-reviewed literature. To examine how states may change their Medicaid- and CHIP-funded parent coverage, GAO reviewed CHIPRA and PPACA, and interviewed officials from the Centers for Medicare & Medicaid Services (CMS) within the Department of Health and Human Services (HHS) and eight states with authority to cover parents in their Medicaid and CHIP programs as of CHIPRA's enactment. HHS provided technical comments, which GAO incorporated as appropriate.