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Journal Issue: Health Insurance for Children Volume 13 Number 1 Spring 2003

Promoting Public Health Insurance for Children
Michael J. Perry


Until the State Children's Health Insurance Program (SCHIP) was adopted in 1997, states were not expected to actively promote their public health programs for children or to encourage enrollment. But the availability of new administrative funds under SCHIP for outreach and marketing spurred states to create marketing campaigns to raise awareness about and increase involvement in SCHIP and Medicaid. At the same time, many of these activities were new, and states had little experience in developing marketing materials and advertising campaigns. Over time, however, states gained skill and expertise in promoting their children's health programs.

As states began marketing SCHIP, they also started to focus on enrolling children in Medicaid. Historically, states did not promote Medicaid enrollment because most families were automatically enrolled when they signed up for welfare, or Aid to Families with Dependent Children (AFDC). In 1996, however, welfare reform eliminated the link between eligibility for Medicaid and AFDC, giving Medicaid the opportunity to redefine itself as a health insurance program for low-income families. (See the article by Mann, Rowland, and Garfield in this journal issue.) State advertisements and outreach strategies used to encourage enrollment in SCHIP were also used to encourage enrollment in Medicaid.

This article examines how states marketed their SCHIP and Medicaid programs and identifies lessons learned from these efforts. The article focuses primarily on state advertising and marketing campaigns—since these were such new activities for public health programs that serve children—and less on outreach efforts that occurred at the community level.

To describe state marketing and message strategies, this article draws on a 2000 study conducted for the Kaiser Commission on Medicaid and the Uninsured. The study included in-depth interviews with 55 officials responsible for SCHIP outreach in 48 states (including Washington, D.C.).1,2 In addition, the study reviewed and analyzed 37 print ads, 24 television ads, and 15 radio ads from 38 states. The purpose of these efforts was to create a baseline of information about states' marketing efforts for SCHIP and Medicaid and to identify common as well as innovative approaches and messages states used. Insights from these interviews and an analysis of state marketing materials for SCHIP and Medicaid form the basis for this article.3

The article first discusses the various strategies states used to market their children's health coverage programs. It then reviews the most common messages used to encourage parents to enroll their eligible children in a coverage program, and it briefly discusses efforts to evaluate the effectiveness of state marketing campaigns. Finally, the article concludes with a review of the lessons learned through these efforts and offers suggestions on how these lessons can be incorporated into future children's health coverage campaigns.