The effects of cost-shifting in the state children's heath insurance program

American Journal of Public Health
Tricia J JohnsonWilliam G Johnson

Abstract

Many states are increasing the State Children's Health Insurance Program (SCHIP) cost-sharing requirements to induce reductions in enrollment. We examined the effect of increasing SCHIP premiums on both health care use and cost to the public. The net cost to the public of increased cost sharing for SCHIP-insured children in a border community was estimated with multivariate methods. The majority (88%) of children were of Mexican origin. We estimated that a $10 increase in monthly premiums would induce 10% of SCHIP children to disenroll, resulting in a 6% increase in public expenditures. Families that disenroll from SCHIP and become uninsured typically turn to emergency departments for primary care, which increases total health care expenditures through the use of more expensive services.

Citations

Mar 29, 2012·JAMA : the Journal of the American Medical Association·Pinar Karaca-MandicDana P Goldman
Sep 18, 2013·The Journal of Asthma : Official Journal of the Association for the Care of Asthma·Norma Alicea-AlvarezSteven G Kelsen
Mar 29, 2008·Academic Emergency Medicine : Official Journal of the Society for Academic Emergency Medicine·Renee Y HsiaLaurence C Baker
Jun 5, 2013·Health Affairs·Pinar Karaca-MandicBenjamin D Sommers
May 3, 2007·Pediatrics·Mary E RimszaWilliam G Johnson

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