Wisconsin's BadgerCare Plus reform: impact on low-income families' enrollment and retention in public coverage.
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OBJECTIVES: To examine the impact of a Wisconsin health care reform enacted in early 2008 on public insurance enrollment and retention. DATA SOURCES: Administrative data covering the period January 2007 to November 2009. STUDY DESIGN: We calculate unadjusted enrollment trends and exit rates stratified by age, income group, and enrollment mode. Kaplan-Meier curves and Cox proportional hazards models are estimated to assess the impact of the reform on program exits. PRINCIPAL FINDINGS: Overall enrollment increased by approximately one-third and exit rates decreased by approximately one-fifth. The majority of new enrollment came from the previously income eligible. CONCLUSIONS: Wisconsin's enactment of eligibility expansions coupled with administrative simplification and targeted marketing and outreach efforts were successful in enrolling and retaining low-income children and families in public coverage.