The Effects of Cumulative Enrollment in the Children’s Health Insurance Program on Child Health and Academic Performance

This study seeks to provide new evidence on the health and education effects of the Children’s Health Insurance Program (CHIP). Unlike most previous studies that focus on the effects of eligibility for a single year, we examine how cumulative enrollment in CHIP over a period of several years affects health care utilization, health outcomes, and academic performance among school-age children. We use a simulated eligibility instrument to address the endogeneity of enrollment in CHIP due to individual-level selection and state-level variation in demographic composition. Using data from the Early Childhood Longitudinal Study, Kindergarten Class of 1998-1999 for the years 1999-2007, we find that an additional year of CHIP enrollment is associated with a 9 percentage-point increase in the parent-reported probability that a child has not gone a year or more without a routine checkup. However, we do not find any association between CHIP enrollment and improved parent-assessed health status or reduced incidence of obesity. Also, we do not find any detectable effect on academic performance as measured by standardized test scores in reading and math.