Get Updates via Email Get Updates Get our RSS Feed
  Follow Mathematica on Twitter  Share/Save/Bookmark

At a Glance


David and Lucile Packard Foundation

Project Time Frame:


Project Publications



Insuring America's Children

Due to growth in the two major public coverage programs for children, Medicaid and the Children’s Health Insurance Program (CHIP), the percent of children without health insurance has declined consistently reaching, in 2010, its lowest level since official data have been collected. Despite the tumultuous environment in recent years—a severe economic downturn, continued erosion of private insurance, and intense debate over national health reform—states have been able to secure significant gains in coverage, facilitated by the CHIP Reauthorization Act, provisions of the Patient Protection and Affordable Care Act, and efforts of child and family advocates working within individual states and networked across states. Insuring America’s Children, a multi-year grantmaking strategy of the David and Lucile Packard Foundation, strives to move all states toward the goal of attaining health coverage for all children by investing in targeted states that could show success and, in turn, influence other states to advance as well.

Insuring America’s Children began in 2007 with the Narrative Communications Project which provides competitive grant support and targeted technical assistance and training from Spitfire Strategies to strengthen the strategic communications efforts of state-based advocacy groups working to grow children’s health insurance coverage. The Finish Line Project, launched the following year, provides multi-year grant support; continued communications support from Spitfire Strategies; and training, support for policy analysis, and technical assistance from the Center for Children and Families at Georgetown University's Health Policy Institute. A third component of Insuring America’s Children provides funding for the National Academy for State Health Policy to support state officials working on children’s coverage through peer-to-peer learning and technical assistance.

Mathematica’s evaluation of Insuring America’s Children aims to monitor the progress of the grantmaking strategy, identify effective advocacy activities, and inform decisionmakers in states and at the national level about promising coverage strategies and programs. In the first phase of the evaluation, the project team conducted in-depth site visits to six of the Finish Line states to gather insights and perspectives on the issue of children’s health coverage and the environment for expansion in each state. In an ongoing second phase, the project team is conducting a retrospective study of the state-level grantees’ activities, including both the Narrative Communications Project and the Finish Line Project. Evaluation partners in the first phase included the Center for Studying Health System Change and the Urban Institute.

Project Publications

"The Narrative Communications Project: Takeaway Findings on a Message-Framing Approach. Evaluation Brief #4" (November 2012)
"Applying Advocacy Skills in Tumultuous Times: Adaptive Capacity of Insuring America's Children Grantees. Evaluation Brief 3" (April 2012) Full Brief; Executive Summary
“Strategic Engagement of Policymakers Is Key to Advancing a Children’s Health Care Coverage Policy Agenda. Evaluation Brief 2” (July 2010)
“State-Based Advocacy as a Tool for Expanding Children’s Coverage: Lessons from Site Visits to Six IAC Grantee States. Evaluation Brief 1” (July 2010)