Policy Adoption of the Special Design (SD) Provision in the State Children's Health Insurance Program

Abstract

AbstractIntroduction: Political partisanship and institutional arrangement can influence a state's decision to include special provisions (e.g., a premium assistance program, an enrollee buy‐in program, coverage expansion and health services initiatives) in the State Children's Health Insurance Program (SCHIP). Methods: Four published sources of data on SCHIP for 2005 were subjected to a logistic regression analysis to investigate the political and practical relationships. Results: The logistic regression analysis reveals that a Democratic governor and dominance in both the upper and lower legislative bodies combined with the existence of a SCHIP increase the likelihood that special design features will be adopted. Conclusion: Democratic political dominance in United States favors expanded SCHIP. States with more limited income eligibility are less likely to adopt special design provisions. The dominance of liberal ideology in politics, an increased organizational flexibility and the existing scope of beneficiaries provide the conditions for addressing a new children's health policy in international countries.