ABSTRACT
State's initial choices, under the State children's health insurance program (SCHIP), of Medicaid expansion (M-SCHIP), separate state plan (S-SCHIP), or combination program (C-SCHIP) have received attention in the public administration literature. This chapter establishes statistically significant links between choice of administrative model and program enrollment and retention. A more nuanced interpretation of this key administrative choice will re-establish its relevance to the expansion of coverage for children. The chapter proposes a conceptual framework in which expansion of coverage for children is the dependent variable. It analyses states' administrative choices, and explores the relevance of federal parameters and state contextual characteristics in influencing those choices. Likewise cognizant of the number and complexity of methodologies for measuring expansion, the chapter provides a simple state-centered concept of expansion that refers to changes versus a state's baseline SCHIP enrollment. Scrutiny of administrative choices under SCHIP endorses that structural choices have important consequences for the content and direction of policy, and political actors know it.
