The effects of state policy design features on take‐up and crowd‐out rates for the state children's health insurance program

Dados Bibliográficos

ID11684609
AutoresCynthia Bansak (0000-0002-4551-1459, San Diego State University, autor correspondente), Steven Raphael (0000-0001-9243-2182, University of California, Berkeley)
Ano2006
Volume26
Fascículo1
Páginas149-175
Data de publicação2006-11-29
Peer ReviewedSim
Open AccessSim
TipoARTICLE
PeriódicoJournal of Policy Analysis and Management (JOURNAL)
Identificadores do periódicoISSN: 0276-8739 • E-ISSN: 1520-6688
EditoraWiley (PUBLISHER • GB)
DOI10.1002/pam.20231
PMID17312602
OpenAlexW2071121251
IdiomaEN
Citações recebidas24
Referências citadas18

We evaluate the effects of state policy design features on SCHIP take-up rates and on the degree to which SCHIP benefits crowd out private benefits. The results indicate overall program take-up rates of approximately 10 percent. However, there is considerable heterogeneity across states, suggesting a potential role of inter-state variation in policy design. We find that several design mechanisms have significant and substantial positive effects on take-up. For example, eliminating asset tests, offering continuous coverage, simplifying the application and renewal processes, and extending benefits to parents all have sizable and positive effects on take-up rates. Mandatory waiting periods, on the other hand, consistently reduce take-up rates. In all, inter-state differences in outreach and anti-crowd-out efforts explain roughly one-quarter of the cross-state variation in take-up rates. Concerning the crowding out of private health insurance benefits, we find that between one-quarter and one-third of the increase in public health insurance coverage for SCHIP-eligible children is offset by a decline in private health coverage. We find little evidence that the policy-induced variation in take-up is associated with a significant degree of crowd out, and no evidence that the negative effect on private coverage caused by state policy choices is any greater than the overall crowding-out effect. This suggests that states are not augmenting take-up rates by enrolling children that are relatively more likely to have private health insurance benefits

Actuarial science · Asset (computer security · Business · Crowding · Crowding out · Demographic economics · Economic growth · Economics · Geography · Health care · Medicaid · Monetary economics · Outreach · Private insurance · Public economics · Quarter (Canadian coin · Gender, Labor, and Family Dynamics · Healthcare Policy and Management · Primary Care and Health Outcomes · Psychology