Medicaid Disenrollment Patterns Among Children Coming into Contact with Child Welfare Agencies

Ramesh Raghavan, Benjamin T. Allaire, Derek S. Brown, Raven E. Ross

Research output: Contribution to journalArticlepeer-review


Objectives To examine retention of Medicaid coverage over time for children in the child welfare system. Methods We linked a national survey of children with histories of abuse and neglect to their Medicaid claims files from 36 states, and followed these children over a 4 year period. We estimated a Cox proportional hazards model on time to first disenrollment from Medicaid. Results Half of our sample (50 %) retained Medicaid coverage across 4 years of follow up. Most disenrollments occurred in year 4. Being 3–5 years of age and rural residence were associated with increased hazard of insurance loss. Fee-for-service Medicaid and other non-managed insurance arrangements were associated with a lower hazard of insurance loss. Conclusions for Practice A considerable number of children entering child environments seem to retain Medicaid coverage over multiple years. Finding ways to promote entry of child welfare-involved children into health insurance coverage will be critical to assure services for this highly vulnerable population.

Original languageEnglish (US)
Pages (from-to)1280-1287
Number of pages8
JournalMaternal and Child Health Journal
Issue number6
StatePublished - Jun 1 2016


  • Attrition
  • Child maltreatment
  • Medicaid
  • Retention

ASJC Scopus subject areas

  • Epidemiology
  • Pediatrics, Perinatology, and Child Health
  • Obstetrics and Gynecology
  • Public Health, Environmental and Occupational Health


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