{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T20:13:47Z","timestamp":1788984827832,"version":"build-2803163510"},"reference-count":66,"publisher":"Health Affairs Publishing, LLC","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Affairs"],"published-print":{"date-parts":[[2026,9,1]]},"DOI":"10.1377\/hlthaff.2025.01634","type":"journal-article","created":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:30:36Z","timestamp":1788982236000},"page":"1018-1026","source":"Crossref","is-referenced-by-count":0,"title":["Medicaid\/CHIP Income Thresholds And Health Services Use Among Children In Low-Income Households, 2016\u201323"],"prefix":"10.1377","volume":"45","author":[{"given":"Cristian R.","family":"Ramos","sequence":"first","affiliation":[{"name":"Cristian R. Ramos (), Emory University, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xu","family":"Ji","sequence":"additional","affiliation":[{"name":"Xu Ji, Emory University and Children\u2019s Healthcare of Atlanta, Atlanta, Georgia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hefei","family":"Wen","sequence":"additional","affiliation":[{"name":"Hefei Wen, Emory University."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janet R.","family":"Cummings","sequence":"additional","affiliation":[{"name":"Janet R. Cummings, Emory University."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"102","reference":[{"key":"B1","unstructured":"Shrider EA. Poverty in the United States: 2023 [Internet]. Suitland (MD): Census Bureau; 2024 Sep [cited 2026 Jul 22]. (Current Population Reports No.\u00a0P60-283). Available from: https:\/\/www2.census.gov\/library\/publications\/2024\/demo\/p60-283.pdf"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2016-0339"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/12.8.667"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2015.05.008"},{"issue":"9","key":"B5","first-page":"291","volume":"46","author":"Oberg C","year":"2016","journal-title":"Curr Probl Pediatr Adolesc Health Care"},{"key":"B6","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2010.08.011"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1080\/07370016.2018.1404832"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2015.02.007"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-017-4363-z"},{"key":"B10","unstructured":"Rudowitz R, Tolbert J, Burns A, Hinton E, Mudumala A, Chidambaram P,  Medicaid 101 [Internet]. San Francisco (CA): KFF; 2025 Oct 8 [cited 2026 Jul 7]. Available from: https:\/\/www.kff.org\/medicaid\/health-policy-101-medicaid\/"},{"key":"B11","unstructured":"KFF. Monthly child enrollment in Medicaid and CHIP [Internet]. San Francisco (CA): KFF; [cited 2026 Jul 22]. (Time frame: Dec 2025). Available from: https:\/\/www.kff.org\/medicaid\/state-indicator\/total-medicaid-and-chip-child-enrollment\/"},{"key":"B12","unstructured":"Haley JM, McMorrow S, Long J, Kenney GM, Johnston EM, Willis C,  Assessing health care access among Medicaid\/CHIP-enrolled children: a national chartbook, 2016\u201319 [Internet]. Washington (DC): Urban Institute; 2023 Apr 6 [cited 2026 Jul 7]. Available from: https:\/\/www.urban.org\/research\/publication\/assessing-health-care-access-among-medicaidchip-enrolled-children"},{"key":"B13","unstructured":"Paradise J. The impact of the Children\u2019s Health Insurance Program (CHIP): what does the research tell us? [Internet]. Washington (DC): Kaiser Commission on Medicaid and the Uninsured; 2014 Jul [cited 2026 Jul 7]. Available from: https:\/\/www.kff.org\/wp-content\/uploads\/2014\/07\/8615-the-impact-of-the-children_s-health-insurance-program-chip-what-does-the-research-tell-us.pdf"},{"key":"B14","unstructured":"Johnston EM, Gates JA, Kenney GM. Medicaid and CHIP for children: trends in coverage, affordability, and provider access [Internet]. Washington (DC): Urban Institute; 2017 Jun [cited 2026 Jul 7]. Available from: https:\/\/www.urban.org\/sites\/default\/files\/publication\/91321\/2001371-medicaid-and-chip-for_children-trends-in-coverage-affordability-and-provider-access.pdf"},{"key":"B15","unstructured":"Kenney GM, Coyer C. National findings on access to health care and service use for children enrolled in Medicaid or CHIP [Internet]. Washington (DC): Medicaid and CHIP Payment and Access Commission; 2012 Mar [cited 2026 Jul 7]. Available from: https:\/\/www.macpac.gov\/wp-content\/uploads\/2012\/03\/National-Findings-on-Access-to-Health-Care-and-Service-Use-for-Children-Enrolled-in-Medicaid-or-CHIP.pdf"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2021.01.009"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2015.3028"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhealeco.2016.12.003"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1257\/aer.20171671"},{"key":"B20","unstructured":"Medicaid and CHIP Payment and Access Commission. Overview of the Affordable Care Act and Medicaid [Internet]. Washington (DC): MACPAC; 2022 Mar 31 [cited 2026 Jul 7]. Available from: https:\/\/www.macpac.gov\/subtopic\/overview-of-the-affordable-care-act-and-medicaid\/"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.2307\/1602499"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.00177"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1002\/pam.10024"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2014.0208"},{"key":"B25","first-page":"2333794X1984036","volume":"6","author":"Adams EK","year":"2019","journal-title":"Glob Pediatr Health"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1177\/1077558712437245"},{"key":"B27","unstructured":"Rudowitz R, Artiga S, Arguello R. Children\u2019s health coverage: Medicaid, CHIP, and the ACA [Internet]. San Francisco (CA): KFF; 2014 Mar 26 [cited 2026 Jul 7]. Available from: https:\/\/www.kff.org\/affordable-care-act\/childrens-health-coverage-medicaid-chip-and-the-aca\/"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1136\/adc.2004.065003"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2020-009308"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2020.4185"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1016\/j.ambp.2008.04.003"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-025-04074-x"},{"key":"B33","unstructured":"Euhus R, Williams E, Burns A, Rudowitz R. Allocating CBO\u2019s estimates of federal Medicaid spending reductions across the states: enacted reconciliation package [Internet]. San Francisco (CA): KFF; 2025 Jul 1 [updated 2025 Jul 23; cited 2026 Jul 7]. Available from: https:\/\/www.kff.org\/medicaid\/allocating-cbos-estimates-of-federal-medicaid-spending-reductions-across-the-states-enacted-reconciliation-package\/"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-018-2526-x"},{"key":"B35","unstructured":"KFF. Medicaid Eligibility and Enrollment Survey [Internet]. San Francisco (CA): KFF; [cited 2026 Jul 30]. Available from: https:\/\/www.kff.org\/series\/medicaid-eligibility-and-enrollment-survey\/"},{"key":"B36","unstructured":"Health Resources and Services Administration, Data Warehouse. Area Health Resources Files [Internet]. Rockville (MD): HRSA; [updated 2026 Jan 29; cited 2026 Jul 7]. Available from: https:\/\/data.hrsa.gov\/topics\/health-workforce\/nchwa\/ahrf"},{"key":"B37","unstructured":"Centers for Medicare and Medicaid Services. EPSDT data [Internet]. Baltimore (MD): CMS; [cited 2026 Jul 22]. Available for download from: https:\/\/www.medicaid.gov\/medicaid\/benefits\/early-and-periodic-screening-diagnostic-and-treatment\/epsdt-data"},{"key":"B38","unstructured":"Centers for Medicare and Medicaid Services. Medicaid, Children\u2019s Health Insurance Program, and Basic Health Program eligibility levels [Internet]. Baltimore (MD): CMS; 2023 Dec 1 [cited 2026 Jul 7]. Available from: https:\/\/www.medicaid.gov\/medicaid\/national-medicaid-chip-program-information\/medicaid-childrens-health-insurance-program-basic-health-program-eligibility-levels"},{"key":"B39","unstructured":"Census Bureau. National Survey of Children\u2019s Health (NSCH) codebook [Internet]. Suitland (MD): Census Bureau; [cited 2026 Jul 7]. Available from: https:\/\/www.census.gov\/data-tools\/demo\/uccb\/nschdict"},{"key":"B41","unstructured":"National Center for Health Statistics. Unmet need [Internet]. Hyattsville (MD): NCHS; 2023 Jun 26 [cited 2026 Jul 7]. Available from: https:\/\/www.cdc.gov\/nchs\/hus\/sources-definitions\/unmet-need.htm"},{"key":"B42","doi-asserted-by":"publisher","DOI":"10.2307\/2137284"},{"key":"B43","doi-asserted-by":"publisher","DOI":"10.1080\/19371918.2024.2323137"},{"key":"B44","doi-asserted-by":"publisher","DOI":"10.1177\/10775587211021172"},{"key":"B45","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2022.01465"},{"key":"B46","unstructured":"Coban M. RBIPROBIT: Stata module to estimate recursive bivariate probit regressions [Internet]. Boston (MA): Boston College, Department of Economics; [cited 2026 Jul 7]. Available from: https:\/\/ideas.repec.org\/c\/boc\/bocode\/s459071.html"},{"key":"B47","unstructured":"Census Bureau. 2023 National Survey of Children\u2019s Health: methodology report [Internet]. Suitland (MD): Census Bureau; 2025 Jan 31 [cited 2026 Jul 7]. Available from: https:\/\/www2.census.gov\/programs-surveys\/nsch\/technical-documentation\/methodology\/2023-NSCH-Methodology-Report.pdf"},{"key":"B48","doi-asserted-by":"publisher","DOI":"10.5811\/westjem.2020.7.48891"},{"key":"B49","doi-asserted-by":"publisher","DOI":"10.1016\/j.childyouth.2009.07.001"},{"key":"B50","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpeds.2015.10.090"},{"key":"B51","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-014-1590-0"},{"key":"B52","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.70034"},{"key":"B53","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2006-1896"},{"key":"B54","doi-asserted-by":"publisher","DOI":"10.1007\/s10995-025-04127-1"},{"key":"B55","doi-asserted-by":"publisher","DOI":"10.1016\/j.ambp.2008.04.007"},{"key":"B56","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6629a1"},{"key":"B57","unstructured":"Williams E, Burns A, Rudowitz R. Putting $880\u00a0billion in potential federal Medicaid cuts in context of state budgets and coverage [Internet]. San Francisco (CA): KFF; 2025 Mar 24 [cited 2026 Jul 7]. Available from: https:\/\/www.kff.org\/medicaid\/putting-880-billion-in-potential-federal-medicaid-cuts-in-context-of-state-budgets-and-coverage\/"},{"key":"B58","unstructured":"Rao P, Baker L, Girosi F, Li E, Kerber R, Eibner C. State-level impacts of key Medicaid provisions in the One Big Beautiful Bill Act [Internet]. Santa Monica (CA): RAND; 2026 Jun 18 [cited 2026 Jul 7]. Available for download from: https:\/\/www.rand.org\/pubs\/research_reports\/RRA4098-1-v2.html"},{"key":"B59","unstructured":"Alker J. Critical threats to child and family health intensify in 2026: here is what we are watching at CCF. Georgetown University Center for Children and Families Blog [blog on the Internet]. 2026 Feb 6 [cited 2026 Jul 7]. Available from: https:\/\/ccf.georgetown.edu\/2026\/02\/06\/critical-threats-to-child-and-family-health-intensify-in-2026-here-is-what-we-are-watching-at-ccf\/"},{"key":"B60","unstructured":"Rosenbaum S, Johnson K, Bodas M, Krips M, Jacobs F. Deep Medicaid spending cuts put health care coverage at risk for one of five enrolled children. Commonwealth Fund Blog [blog on the Internet]. 2025 May 5 [cited 2026 Jul 7]. Available from: https:\/\/www.commonwealthfund.org\/blog\/2025\/deep-medicaid-spending-cuts-put-health-care-coverage-risk-one-five-enrolled-children"},{"key":"B61","doi-asserted-by":"publisher","DOI":"10.1111\/j.1525-1497.2005.40245.x"},{"key":"B62","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2014.01.004"},{"key":"B63","doi-asserted-by":"publisher","DOI":"10.1542\/pir.2018-0027"},{"key":"B64","doi-asserted-by":"publisher","DOI":"10.1016\/j.acap.2017.06.010"},{"key":"B65","unstructured":"Williams E. 5 key facts about children with special health care needs and Medicaid [Internet]. San Francisco (CA): KFF; 2025 Apr 18 [cited 2026 Jul 7]. Available from: https:\/\/www.kff.org\/medicaid\/5-key-facts-about-children-with-special-health-care-needs-and-medicaid\/"},{"key":"B66","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2013.4653"},{"key":"B67","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.51524"}],"container-title":["Health Affairs"],"original-title":[],"language":"en","deposited":{"date-parts":[[2026,9,9]],"date-time":"2026-09-09T19:30:45Z","timestamp":1788982245000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.healthaffairs.org\/doi\/10.1377\/hlthaff.2025.01634"}},"subtitle":["Article examines Medicaid\/CHIP income thresholds and health service use among children in low-income households"],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":66,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"alternative-id":["10.1377\/hlthaff.2025.01634"],"URL":"https:\/\/doi.org\/10.1377\/hlthaff.2025.01634","relation":{},"ISSN":["0278-2715","1544-5208"],"issn-type":[{"value":"0278-2715","type":"print"},{"value":"1544-5208","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]}}}