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Concerns regarding the quality of care provided to Medicaid enrollees and the program’s financial viability have prompted serious consideration of much greater state flexibility in the structuring of Medicaid and the delivery of health care to Medicaid enrollees. Effective July 1, 2006, Florida embarked on a 5-year research and demonstration project that significantly changed its Medicaid program. One element of the Florida reform initiative was the inclusion of provider service networks (PSNs).

Two-thirds of children in the United States were income-eligible for Medicaid or the State Children’s Health Insurance Program (SCHIP) at some point from 1996 to 2000. One in five children were income-eligible for both programs, and 73 percent of children ever eligible for SCHIP were eligible at other times for Medicaid. As SCHIP is reauthorized, Congress will need to give states the tools and financial commitment to assure that uninsured children are enrolled in and retain the coverage for which they are eligible.