Urban Institute Studies How State and Federal Policy Changes Impact Health and Welfare of Families and Children

Assessing the New Federalism is an Urban Institute project that tracks the impact of state and federal policy changes on: (1) the health and social welfare of families and children; and (2) the structure of health and social welfare programs. As part of this project, the Robert Wood Johnson Foundation (RWJF):

  • Funded an assessment of the State Children's Health Insurance Program (CHIP).
  • Funded an assessment of federalism and health policy.
  • Partially supported health data collection and analysis through the National Survey of America's Families and through in-depth case studies of 13 states.

Key Findings

  • Medicaid and CHIP face considerable financial stress and would benefit from a broad restructuring, including higher levels of mandated coverage and greater federal financial contributions.

  • CHIP, together with the Medicaid outreach and enrollment simplification efforts that accompanied it, led to reductions in the number of children who are uninsured.

  • The wide variation in employer-sponsored coverage across states is a major contributor to a corresponding variation in uninsurance rates.