Expanding Coverage for Children: Santa Clara County Children's Health Initiative

The Santa Clara County Children's Health Initiative (CHI) is an innovative effort to expand health insurance coverage of children in the county. CHI has two parts. The first is a new insurance product, Healthy Kids, which covers children in households with income up to 300 percent of the federal poverty level who are ineligible for the two major state insurance programs—Medi-Cal and Healthy Families. The second is a comprehensive outreach campaign that finds uninsured children and enrolls them in the appropriate program.

Mathematica and its subcontractors, the Urban Institute and the University of California at San Francisco, conducted an initial evaluation of CHI for the David and Lucile Packard Foundation. The evaluation had three components: (1) a process analysis consisting of site visits, telephone interviews, and focus groups to document the ongoing goals and challenges of CHI; (2) an impact analysis of Healthy Kids, which measured the impact of CHI on such outcomes as access to health care and unmet needs for health care; and (3) an enrollment analysis, which estimated the effects of CHI and Healthy Kids on the number of children and families enrolling in Medi-Cal and Healthy Families. Of particular interest to the evaluation were the effects for Hispanic children, who are far more likely than children of other major racial/ethnic groups to be both eligible for these programs and uninsured.

The latest brief combines the findings on dental care use and access from the Santa Clara study with the findings from two other independent evaluations of Healthy Kids programs (in Los Angeles and San Mateo Counties). Across all three counties, evaluation findings show positive impacts on children's access and use of dental services.

Project Publications

Cross-County Findings

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