Office of Epidemiology and Research, Division of Research

Advancing Applied MCH Research

(SDAS) The Changing Role of SCHIP in Serving Children with Special Health Care Needs

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Project Number: R40 MC 11281-01
Grantee: RAND Corporation
Department/Center: Pittsburgh Division
Project Date: 2/1/2009

Final Report

(SDAS) The Changing Role of SCHIP in Serving Children with Special Health Care Needs Final Report (PDF) Exit Disclaimer

Principal Investigator

Hao Yu, Ph.D.
Policy Researcher
4570 Fifth Avenue Suite 600
Pittsburgh, PA  15101
Phone: 412-683-2300 x4460


  • Perinatal/Infancy (0-12 months)
  • Toddlerhood (13-35 months)
  • Early Childhood (3-5 years)
  • Middle Childhood (6-11 years)
  • Adolescence (12-18 years)


Given the struggle over SCHIP reauthorization, including two presidential vetoes in 2007, and the expectation that Congress will take on the SCHIP reauthorization again in 2009, new information about the effects of SCHIP may be particularly important for policymakers. Recent trends in SCHIP eligibility, coverage, and access to care among vulnerable groups of children, such as those with special health care needs, can help prepare policymakers for the upcoming debate. This project will provide current and detailed information about these trends. As an extension of our prior work using the 2001 National Survey of Children with Special Health Care Needs (NS-CSHCN), we will use both the 2001 and the 2005-2006 NS-CSHCN to analyze the trends. In particular, we will merge the NS-CSHCN data with detailed information about State-specific SCHIP policies. The merged dataset will be used to examine three specific aims: 1. To assess trends in SCHIP-eligibility for CSHCN; 2.To examine trends in the proportion of CSHCN who are SCHIP-eligible but uninsured; and 3.To investigate trends in access to health care for the SCHIP-enrolled CSHCN. Findings from this empirical analysis can help inform policy-making on health care financing for CSHCN, especially at a time when the Congress is expected to take on SCHIP reauthorization again in 2009. The proposed project addresses the MCHB Strategic Research Issue #I Public health service systems and infrastructures at the community, State and/or national levels, as they apply to different maternal and child health (MCH) populations based on demographic, epidemiological, and/or other factors. In this study, the State and national level systems and infrastructures are SCHIP programs in the 50 States and the District of Columbia, and the MCH population is CSHCN. The project also addresses the MCHB Strategic Research Issue #II MCH services and systems of care efforts to eliminate health disparities and barriers to health care access for MCH populations. In this study, we will identify barriers to health care access for CSHCN. The project is also related to the Healthy People 2010 Goal: Improve the health and well-being of women, infants, children, and families. In particular, it is closely related to the Healthy People 2010 objective of Service systems for children with special health care needs.


Listed is descending order by year published.

Yu H, Dick AW. Impacts of rising health care costs on families with employment-based private insurance: a national analysis with state fixed effects. Health Services Research. 2012;47(5):2012-2030.

Yu H, Dick AW. Recent trends in state children's health insurance program eligibility and coverage for CSHCN. Pediatrics. 2009 Dec;124 Suppl 4:S337-42.


Insurance Coverage, Special Health Care Needs, Access to Health Care

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