Policy and Advocacy for Improving Population Health

Health Care Policy

Children’s Health Insurance Program (CHIP)

Description

CHIP programs were designed to provide health care to children living in low-income households. In this regard, the CHIP health care policy originated from the children's Health insurance authorization act of 2009(Perrin & Hall, 2015). Thus, the primary objective of the CHIP policy is to provide insurance cover to unprivileged children by accruing funds from the federal and state.

Policy Outcomes

Studies in California revealed that the implementation of the CHIP policy was correlated with a reduction in hospitalization, suggesting that primary access and quality for low incomes improved (Paradise, 2014). Besides, another study found a 10% point increase in CHIP eligibility from 30% of children to 40%. Thus, the policy has impacts on children's health and a reduction in the rate of mortality. Besides, the program also increased access for children with chronic and special health care needs.

Success Measures

The success of the policy was measured based on the reported number of child mortality rates and the rate of hospitalization among children from low-income families (Paradise, 2014). Also, the rate of success was measured based on the use of prevention and primary care.

People reached

The CHIP program is administered in each state in adherence to federal laws (Medicaid.gov, 2015). After implementation, over 9.6 million children were enrolled in the programs.

Data used in the evaluation

Data from the uninsured population was used to conduct the CHIP program. In this regard, the CHIP program was a block grant and not an entitlement program. Thus, data from the uninsured population in the respective state formed the basis of the program's evaluation.

Stakeholders

The stakeholders in the programs evaluation were both federal, state, and health players in the health care settings. In particular, due to the nature of the finding, the federal governments were the major stakeholders.

Unintended Consequence

The increased public coverage depicted the consequence of the CHIP program by 14-20% and a decline in ESI of the 7 percentage points. Besides, the reduction in insurance of between 7 and 13 % points was a positive but unintended consequence (Dubay & Kenney, 2009). Other benefits were depicted by the improved quality of life among children from low-income groups and resultant decreased hospitalization rates. It was also reported that the out-of-pocket expenses and medical expenses decreased with implementing the CHIP program among the low-income groups. However, the program's implementation in some states did not correlate with the administrative data(Paradise, 2014). In particular, in the state of Virginia, the progress for child coverage was inconsistent. In essence, the Current population survey revealed that the enrollment of children in insurance programs increased during the implementation of the CHIP while the administration date showed a decline. Additionally, Paradise (2014) reported that premiums, deductibles, and cost-sharing were low in the CHIP program. The other negative impact is associated with the low dentist participation in CHIP.

Intent and objective

Originally, the programs were designed to cater to the health care needs of children from low-income groups who Medicaid and Medicare sidelined. Besides, the other objective was to provide cost-effective healthcare programs to families that could not afford other forms of insurance. Based on past studies and the impacts of the programs, it can be argued that the program's objectives and the intent were achieved(Dubay & Kenney, 2009). The increased insurance rates depict this among the children and better outcomes in terms of health care utilization. It was also reported that child and maternal health also improved significantly. Paradise (2014) also mentioned that state policymakers, advocates, and child coverage experts were the crucial stakeholders that leveraged CHIP data in decision-making. Apart from the health access intent, the programs also cautioned families from low-income groups.

Recommendation

To improve the efficacy of the CHIP programs, there is a need to regulate the entry eligibility to prevent covering children above the 250 poverty level. Also, both state policymakers and the censuses bureau should be involved in the decision-making aspect of the CHIP to increase the efficacy of the programs and increase the positive outcomes through policy changes (Dubay & Kenney, 2009). Besides, there is a need for frequent state surveys to assess the impacts of the programs on the targeted population. The county data can also be used to evaluate the program's outcomes and the need for policy changes to address the existing gaps. Overall, I would recommend implementing the program at my workplace among employees who cannot afford insurance cover offered by Medicaid and Medicare providers.

Roles of nurse advocate

Nurses play essential roles in addressing the need of the patient due to constant touch and interactions. In this case, I would actively participate in meetings and discussions across the states to ensure that barriers in implementing the programs are omitted. Besides, public education is an important aspect that contributes to the uptake of given health programs. In this case, I would engage in public education among the low-income groups and provide insight on the importance of insurance among marginalized communities. Education and policy meetings can address areas that need improvement based on the data accrued from the evaluation process and my professional input.