Continuous Eligibility Bibliography


Collins, S. R. and Haynes, L. A. Congress Can Give States the Option to Keep Adults Covered in Medicaid. Commonwealth Fund. November 2022.

Medicaid and CHIP Payment and Access Commission. Effects of Churn on Potentially Preventable Hospital Use. July 2022.

Alker, J. et al. The Biden Administration Should Approve Oregon’s Request To Cover Children Until Their Sixth Birthday. Health Affairs Blog. July 2022.  

Haley, J. et al. Children’s Uninsurance Fell between 2019 and 2021, but Progress Could Stall When Pandemic Protections Expire. The Urban Institute. June 2022.  

Wang, X. Extending Postpartum Medicaid Beyond 60 Days Improves Care Access and Uncovers Unmet Needs in a Texas Medicaid Health Maintenance Organization. Frontiers in Public Health. May 2022. 

Lee, R. More States Move to Expand Continuous Eligibility for Children and Adults in Medicaid. Georgetown University Health Policy Institute, Center for Children and Families. May 2022. 

Clark, M. One Year of Medicaid Postpartum Coverage Option Begins Today, More Approvals to Come. Georgetown University Health Policy Institute, Center for Children and Families. May 2022. 

Lukens, G. et al. COVID Relief Provisions Stabilized Health Coverage, Improved Access and Affordability. Center on Budget and Policy Priorities. March 2022.  

Mann, C. Stable and Continuous Coverage Provisions in Medicaid Gain Momentum Through Build Back Better Act. The Commonwealth Fund. February 2022.

Shah, S. and Friedman, F. Medicaid and moms: the potential impact of extending Medicaid coverage to mothers for 1 year after delivery. Journal of Perinatology. February 2022.  

Raphael, J. and Patel, M. Extending public insurance postpartum coverage: implications for maternal and child health. Pediatric Research. February 2022.  

Gordon, S. et al. Extended Postpartum Medicaid Eligibility Is Associated With Improved Continuity Of Coverage In The Postpartum Year. Health Affairs. January 2022. 


JAMA Health Forum. Medicaid Coverage Disruptions Among Children Enrolled in North Carolina Medicaid From 2016 to 2018. December 2021.

Liu, H. and Ku, L. Twelve-Month Continuous Eligibility for Medicaid Adults Can Stabilize Coverage with a Modest Cost Increase. The RAND Blog. December 2021.

Corallo, B., Garfield, R., Tolbert, J., and Rudowitz, R. Medicaid Enrollment Churn and Implications for Continuous Coverage Policies. Kaiser Family Foundation. December 2021.

Alker, J. and Osorio, A. Why is Medicaid/CHIP Continuous Eligibility So Important for Kids? Georgetown University Health Policy Institute, Center for Children and Families. October 2021.

Georgetown University Health Policy Institute, Center for Children and Families. MACPAC Research Shows Closing the Continuous Coverage Gap for Kids is Within Reach. October 2021.

The Association for Community Affiliated Plans & NORC at the University
of Chicago. Voices of Medicaid Enrollees: The Importance of Consistent Coverage. October 2021.

Whitener, K. and Snider, M. Advancing Health Equity for Children and Adults with a Critical Tool: Medicaid and Children’s Health Insurance Program Continuous Coverage. Georgetown University Health Policy Institute, Center for Children and Families & UnidosUS. October 2021. 

Boozang, P. and Striar, A. The End of the COVID-19 Public Health Emergency: Potential Health Equity Implications of Ending Medicaid Continuous Eligibility. Manatt Health. September 2021.

Brantley, E. and Ku, L. Medical Care Research and Review. Continuous Eligibility for Medicaid Associated with Improved Child Health Outcomes. September 2021. Continuous Eligibility for Medicaid and CHIP Coverage. Medicaid. September 2021.

Williams, E. et al. Medicaid and State Financing: Key Indicators to Watch Through Pandemic and Recovery. Kaiser Family Foundation. September 2021.

Journal of the American Medical Association. What Medicare Can Teach Medicaid About Value-Based Care. August 2021.

Georgetown University Health Policy Institute, Center for Children and Families. Continuous Coverage in Medicaid and CHIP. July 2021.

Georgetown University Health Policy Institute, Center for Children and Families. States Move Toward Multi-Year Continuous Eligibility for Children in Medicaid. June 2021.

Erzouki, F. Increased Medicaid Enrollment Underscores Need for Permanent Policies That Keep People Covered. Center for Budget and Policy Priorities. June 2021.

Clemens, J; Ippolito, B; and Veuger, S. Medicaid and Fiscal Federalism during the COVID-19 pandemic.  American Enterprise Institute. May 2021.

Wagner, J and Solomon, J. Continuous Eligibility Keeps People Insured and Reduces Costs. Center on Budget and Policy Priorities. May 2021.

Office of the Assistant Secretary for Planning and Evaluation. Medicaid Churning and Continuity of Care. April 2021.

Rapfogel, N. Building On the ACA To Reduce Health Insurance Disruptions. Center for American Progress, April 2021. 

Sugar, S. et al. Medicaid Churning and Continuity of Care: Evidence and Policy Considerations Before and After the COVID-19 Pandemic. ASPE. April 2021.

The Urban Institute. Closing Postpartum Coverage Gaps and Improving Continuity and Affordability of Care through Postpartum Medicaid/CHIP Extension. January 2021.

The Urban Institute. The Public Health Insurance Landscape for Pregnant and Postpartum Women. January 2021.

The Urban Institute. Closing Gaps in Maternal Health Coverage. January 2021.


The Century Foundation. The Path Toward Equity in COVID-19 Vaccination. November 2020.

The Commonwealth Fund. Tracking State Policies to Improve Maternal Health Outcomes. November 2020.

Center on Budget and Policy Priorities. Continuous Coverage Protections in Families First Act Prevent Coverage Gaps by Reducing “Churn”. July 2020.

Members of the Equitable Maternal Health Coalition. Making the Case for Extending Medicaid Coverage Beyond 60 Days Postpartum: A Toolkit for State Advocates. June 2020.

Ku, Leighton and Brantley, Erin. Continuous Medicaid Eligibility for Children and Their Health. George Washington University Milken Institute School of Public Health. June 2020.

Whitener, Kelly and Alker, Joan. Covering Kids. Georgetown University Health Policy Institute, Center for Children and Families. February 2020.

Health Affairs. Among Low-Income Adults Enrolled In Medicaid, Churning Decreased After The Affordable Care Act. January 2020.


Kaiser Health News/National Public Radio. Return To Sender: A Single Undeliverable Letter Can Mean Losing Medicaid. November 2019.

Health Affairs. Association Of State Policies With Medicaid Disenrollment Among Low-Income Medicare Beneficiaries. July 2019

Office of the Assistant Secretary for Planning and Evaluation. Loss of Medicare-Medicaid Dual Eligible Status: Frequency, Contributing Factors and Factors. May 2019.

Families USA. The Return of Churn: State Paperwork Barriers Caused More Than 1.5 Million Low-Income People to Lose Their Medicaid Coverage in 2018. April 2019.

Allison A et al. Reducing lapses in healthcare coverage in the Individual and Medicaid markets. McKinsey & Company,  2019.


Anthem Public Policy Institute. Continuity of Medicaid Coverage Improves Outcomes for Beneficiaries. June 2018.

Harvard T.H. Chan School of Public Health. ‘Churning’ following the Affordable Care Act hasn’t worsened, but remains a problem. HSPH, June 2018.

Natzke, Brenda and Chao, Sandra.  Continuing with the Same Issuer in Transitions Between Medicaid and the Marketplace; Premium Assistance Models in Arkansas, Iowa and New Hampshire. Mathematica, 2018.

University of Michigan. Insurance Gaps Costly for Those with Type Type 1 Diabetes. Health Affairs, 2018.


Jamie R. Daw et al. Women In The United States Experience High Rates Of Coverage ‘Churn’ In Months Before And After ChildbirthHealth Affairs, 2017.


Health Affairs. Insurance Churning Rates For Low-Income Adults Under Health Reform: Lower Than Expected But Still Harmful For Many. October 2016.

Roberts, Eric T. and Pollack, Craig Evan. Does Churning in Medicaid Affect Health Care Use? May 2016.

Allison, Andy et al. Transitions in coverage type are the norm for most consumers over time. McKinsey & Company, 2016.

Cardwell, Anita. Revisiting Churn: An Early Understanding of State-Level Health Coverage Transitions Under the ACA. NASHP, 2016.


Leighton Ku, Erika Steinmetz, Tyler Bysshe. George Washington University. Continuity of Medicaid Coverage in an Era of Transition. November 2015.

Pati S et al. Medicaid and CHIP Retention Among Children in 12 States. Academic Pediatrics, 2015.

Planalp C et al. Measuring and Monitoring Churn at the State Level: Methods and Data Sources. SHADAC, 2015.

Rosenbaum, D. Lessons Churned: Measuring the Impact of Churn in Health and Human Services Programs on Participants and State and Local Agencies. Center on Budget and Policy Priorities, March 2015.

Swartz K et al. Reducing Medicaid Churning: Extending Eligibility For Twelve Months Or To End Of Calendar Year Is Most Effective. H Affairs, 2015.

SHARE. Sub-Annual Income Fluctuations and Eligibility for Coverage Assistance Under the ACA. SHADAC, 2015.


Dawes AJ et al. The Impact of Continuous Medicaid Enrollment on Diagnosis, Treatment, and Survival in Six Surgical Cancers. HSR, 2014.

Planalp C et al. ACA Coverage Expansions: Measuring and Monitoring Churn at the State Level. SHADAC, 2014.

Addressing Churn: Coverage Dynamics in Oregon’s Insurance Affordability Programs. Oregon Medicaid Advisory Committee, 2014.

Hussey PS et al. Continuity and the Costs of Care for Chronic Disease. JAMA Internal Medicine, 2014.

Lines LM, Urato M, Halpern MT, Subramanian S. Insurance Coverage and Preventative Care Among Adults. RTI International, 2014.

Klineberg et al. What Accounts for Health Disparities? Findings from the Houston Surveys (2001-2013). Rice University, 2014.

Dietz M et al. The Ongoing Importance of Enrollment: Churn in Covered California and Medi-Cal. UC Berkeley, 2014.

Cowburn S et al. Insurance Continuity & Human Papillomavirus Vaccine Uptake in Oregon and California Federally Qualified Health Centers. AJPH, 2014.

Simon AE et al. Medicaid Enrollment Gap Length and Number of Medicaid Enrollment Periods Among US Children. AJPH, 2014.

Sommers B et al. Medicaid & Marketplace Eligibility Changes Will Occur Often in All States; Policy Options Can Ease Impact. Health Affairs, 2014.

Riley GF et al. Understanding Factors Associated With Loss Of Medicaid Coverage Among Duals Can Help Identify Vulnerable Enrollees. H Aff., 2014.

Rosenbaum S. Addressing Medicaid/Marketplace Churn through Multimarket Plans: Current State of Play. J Health Politics, Policy & Law, 2014.

Lewandowski, K. Churn Toolkit: Policy Approaches to Reducing Churn. Community Catalyst, 2014. 

Medicaid and CHIP Payment and Access Commission. Promoting Continuity of Medicaid Coverage among Adults under Age 65. MACPAC, 2014


Leighton Ku and Erika Steinmetz, George Washington University. Bridging the Gap: Continuity and Quality of Coverage in Medicaid. September 2013.

Leighton Ku and Erika Steinmetz, George Washington University. The Continuity of Medicaid Coverage: An Update. April 2013.

Baugh, David K and Shinu Verghese. Migration Patterns for Medicaid Enrollees 2005-2007. Medicare & Medicaid Research Review, 2013.

Bazinsky, Kate and Bailit, Michael. The Significant Lack of Alignment Across State and Regional Health Measure Sets. Bailit Health Purchasing, 2013.

Gov’t Accountability Office. Medicare: Continuous Insurance before Enrollment Associated with Better Health and Lower Program Spending. 2013.

Howard and Shearer. State Efforts to Promote Continuity of Coverage and Care under the Affordable Care Act. J Health Politics, Policy and Law, 2013.

Ku et al Continuous eligibility policies stabilize Medicaid coverage for children and could be extended to adults with similar results. H Aff, 2013.

Bouchery E. Utilization of Dental Services Among Medicaid Enrolled Children. Medicare & Medicaid Research Review, 2013.

Yamauchi M et al. Does health insurance continuity among low-income adults impact their childrens insurance coverage? Matern Child Health J, 2013.


Gov’t Accountability Office. States Made Multiple Program Changes and Beneficiaries Generally Reported Access Comparable to Private Insurance. 2012.

Hwang, A et al. Creation of State Basic Health Programs Would Lead To 4% Fewer People Churning Between Medicaid and the Exchanges. H Aff, 2012.

Buettgens M et al. Churning Under the ACA and State Policy Options for Mitigation. Urban and RWJF, 2012.

Ginde A et al. Health Insurance Status Change and Emergency Department Use Among US Adults. Arch Intern Med, 2012.

Wright, Bill and Matthew Carlson. The OHP Standard Disenrollment Study Final Report. 2012.

Wright, Bill and Matthew Carlson. The Healthy Kids Disenrollment Study Final Report. 2012.


Sommers B, Rosenbaum S. How Changes in Eligibility May Move Millions Back and Forth Between Medicaid and Insurance Exchanges. Health Affairs, 2011.

Kenney GM et al. Monitoring Duration of Coverage in Medicaid and CHIP to Assess Program Performance and Quality. Acad Pediatr, 2011.


Lavarreda SA et al. 12-Month Continuous Eligibility in Medicaid: Impact on Service Utilization. UCLA Center for Health Policy Research, 2010.

Sommers, Benjamin D. Enrolling Eligible Children in Medicaid and CHIP: A Research Update. Health Affairs, 2010.

Seifert R et al. Enrollment and Disenrollment in MassHealth and Commonwealth Care. Mass. Medicaid Policy Institute, 2010.

Banerjee et al. Impact of discontinuity in health insurance on resource utilization. BMC Health Services Research, 2010.

Guthrie et al. Health Plan Competition For Medicaid Enrollees Based On Performance Does Not Improve Quality Of Care. Health Affairs, 2010.


Leighton Ku et al, George Washington University. Improving Medicaid’s Continuity of Coverage and Quality of Care. July 2009.

Zhang, J et al. Insurance Status and Quality of Diabetes Care in Community Health Centers. American Journal of Public Health, 2009.

Gold R et al. Insurance Continuity and Receipt of Diabetes Preventive Care in a Network of Federally Qualified Health Centers. Med Care, 2009.

Cummings et al. The Effects of Varying Periods of Uninsurance on Children???s Access to Health Care. Pediatrics, 2009.

Perry, M. Reducing Enrollee Churning in Medicaid, Child Health Plus and Family Health Plus: Findings from Eight Focus Groups. NY Health Fdn., 2009.

Sommers, B. Loss Of Health Insurance Among Non-Elderly Adults In Medicaid. Journal of General Internal Medicine, 2009.

Czajka JL, Mabli J. Analysis of transition events in health insurance coverage: Final report. Mathematica Policy Research, 2009.


Hall AG et al. Lapses in Medicaid coverage: Impact on cost and utilization among individuals with diabetes. Medical Care, 2008.

Fairbrother G, Schuchter J. Stability and Churning in Medi-Cal and Healthy Families. The California Endowment, 2008.


Sommers BD. Why Millions of Children Eligible for Medicaid and SCHIP are Uninsured: Poor Retention Versus Poor Take-Up. Health Affairs, 2007.

Fairbrother GL, Emerson HP, Partridge L. How Stable Is Medicaid Coverage For Children? Health Affairs, 2007.


Harman JS, et al. Changes in health care use and costs after a break in Medicaid coverage among persons with depression. Psychiatric Services, 2008.

Shulmna S, Rosenbach M, Kuo S. SCHIP at 10: A Synthesis of the Evidence on Retention. Mathematica Policy Research, 2006.

Carlson et al. Short-Term Impacts of Coverage Loss in a Medicaid Population. Annals of Family Medicine, 2006.

Boozang P, Braslow L, Fiori A. Coverage Gaps Undermine the Managed Care System and Continuity of Care for the Chronically Ill. Manatt, 2006.


Boozang P, Braslow L, Fiori A. Coverage Gaps Undermine the Managed Care System and Continuity of Care for the Chronically Ill. Manatt, 2006.

Satchell MS, Pati S. Insurance Gaps Among Vulnerable Children in the United States, 1999-2001. Pediatrics, 2005.

Sommers, Benjamin D. The Impact of Program Structure on Childrens Disenrollment from Medicaid and SCHIP. Health Affairs, 2005.

Redmond, P. Medicaid & SCHIP Retention in Challenging Times: Strategies from Managed Care Organizations. Center on Budget & Policy Priorities, 2005.

Fairbrother, Gerry. How Much Does Churning in Medi-Cal Cost? The California Endowment and The Commonwealth Fund, 2005.

Sommers, Benjamin D. From Medicaid to Uninsured: Drop-Out among Children in Public Insurance Programs. Health Services Research, 2005.

Olson et al. Children in the United States with Discontinuous Health Insurance Coverage. NEJM, 2005.


Landon B, Schneider E, Tobias C, Epstein A. The Evolution of Quality Management in Medicaid Managed Care. Health Affairs, 2004.

Fairbrother G et al. Costs of Enrolling Children in Medicaid and SCHIP. Health Affairs, 2004.


Lipson K, et. al. Rethinking Recertification: Keeping Eligible Individuals Enrolled in N.Y.’s Public Health Ins. Program. Commonwealth Fund, 2003.


Irvin, C. et al. Discontinuous Coverage in Medicaid and Implications for 12-Month Continuous Coverage. Mathematica Policy Research, 2001.