Crowd-out in the State Children's Health Insurance Program (SCHIP): Incidence, enrollee characteristics and experiences, and potential impact on New York's SCHIP
Health Services Research
Volume 43 (Issue 1, Part 2)
Child Health Services--statistics & numerical data; Insurance, Health--statistics & numerical data; State Health Plans--statistics & numerical data; Medicaid & SCHIP
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.
Shone, L.P., Lantz, P.M., Dick, A.W., Chernew, M.E., Szilagyi, P.G. (2008). Crowd-out in the State Children's Health Insurance Program (SCHIP): incidence, enrollee characteristics and experiences, and potential impact on New York's SCHIP. Health Services Research, 43(1 pt. 2), 419-434.