Title

Crowd-out in the State Children's Health Insurance Program (SCHIP): Incidence, enrollee characteristics and experiences, and potential impact on New York's SCHIP

Document Type

Journal Article

Publication Date

2-2008

Journal

Health Services Research

Volume

Volume 43 (Issue 1, Part 2)

Inclusive Pages

419-434

Keywords

Child Health Services--statistics & numerical data; Insurance, Health--statistics & numerical data; State Health Plans--statistics & numerical data; Medicaid & SCHIP

Abstract

Background. The extent to which the State Children's Health Insurance Program (SCHIP) crowds our private insurance is poorly understood.

Objective. To assess the incidence of crowd-out and enrollee characteristics associated with crowd-out.

Data. Parent telephone survey for 2,644 children after enrollment in NY SCHIP.

Measures and Analyses. Crowd-out is measured based on enrollee reports of coverage (and loss of coverage) before SCHIP. Multivariate logistic regression is used to relate crowd-out to enrollee characteristics.

Principal Findings. Only 7.1 percent of SCHIP enrollees dropped private coverage ≤6 months before SCHIP, suggesting relatively modest crowd-out. Crowd-out was associated with some enrollee traits including income, but not with health status.

Implications. Most movement from private to public insurance in NY was not crowd-out. Under current program structure in NY, crowd-out concerns should not dampen enthusiasm for SCHIP.

Comments

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Peer Reviewed

1

Open Access

1