Barriers to enrollment in a state child health insurance program

Objective.-To identify barriers to enrollment into Colorado's Child Health Insurance Plan (CHP) for non-Hispanic (NH), Hispanic (H), and uninsured families. Design.-Telephone survey of 1) random samples of families who requested an application but did not complete it (N = 273 NH, N = 159 H) and 2) families with uninsured children identified by random-digit-dial statewide surveys (N = 165). Results.-Major reasons for not enrolling included 1) got other insurance (NH 16.5%; H 27.2% P <.01) 2) thought household income was too high to qualify (NH 21.0%; H 11.9% P =.01), and 3) paperwork (NH 13.4%; H 14.7%, P = NS). Of those who thought their income was too high (N = 76, 17.6%), 58.5% appeared eligible based on reported income. Of uninsured families, only 41.7% had heard of CHP+. Of those who had never applied, major remediable reasons included not knowing enough about the program (20.9%) and thinking household income was too high (9.3%). Conclusions.-Effective marketing and education to increase awareness of CHP+ and ensure understanding of eligibility are critical to the success of the program.