Geographic Variation in Physician Visits for Uninsured Children

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Abstract
The State Children's Health Insurance Program (CHIP), passed by Congress as part of the Balanced Budget Act of 1997, is intended to extend health insurance coverage to a significant proportion of the nation's uninsured children, thereby increasing their access to health care services.1 The program provides for generous federal grants to states, which in turn have substantial latitude in designing the specifics of their programs. Targeted on uninsured children in families with incomes less than 200% of the federal poverty level, CHIP will provide either Medicaid or private insurance coverage. The latter must guarantee a benefit package consistent with state or federal employees' benefits, but with upper limits on cost-sharing amounts to protect low-income children. Most of the states plan to use Medicaid as their CHIP mechanism, either wholly (27 states) or in combination with a private insurance program (10 states).2