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Crowd‐Out in the State Children's Health Insurance Program (SCHIP): Incidence, Enrollee Characteristics and Experiences, and Potential Impact on New York's SCHIP
Author(s) -
Shone Laura P.,
Lantz Paula M.,
Dick Andrew W.,
Chernew Michael E.,
Szilagyi Peter G.
Publication year - 2008
Publication title -
health services research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.706
H-Index - 121
eISSN - 1475-6773
pISSN - 0017-9124
DOI - 10.1111/j.1475-6773.2007.00819.x
Subject(s) - crowding out , logistic regression , crowds , business , medicaid , private insurance , health insurance , actuarial science , demographic economics , medicine , health care , computer science , economics , computer security , economic growth , monetary economics
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.