Take-Up of Public Insurance and Crowd-Out of Private Insurance under Recent CHIP Expansions to Higher Income Children
Article first published online: 19 APR 2012
© Health Research and Educational Trust
Health Services Research
Volume 47, Issue 5, pages 1999–2011, October 2012
How to Cite
Gresenz, C. R., Edgington, S. E., Laugesen, M. and Escarce, J. J. (2012), Take-Up of Public Insurance and Crowd-Out of Private Insurance under Recent CHIP Expansions to Higher Income Children. Health Services Research, 47: 1999–2011. doi: 10.1111/j.1475-6773.2012.01408.x
- Issue published online: 17 SEP 2012
- Article first published online: 19 APR 2012
- Robert Wood Johnson Foundation's State Health Access Reform Effort (SHARE)
- CHIP ;
To analyze the effects of states' expansions of Children's Health Insurance Program (CHIP) eligibility to children in higher income families on health insurance coverage outcomes.
2002–2009 Current Population Survey linked to multiple secondary data sources.
Instrumental variables estimation of linear probability models. Outcomes are whether the child had any public insurance, any private insurance, or no insurance coverage during the year.
Among children in families with incomes between two and four times the federal poverty line (FPL), four enrolled in CHIP for every 100 who became eligible. Roughly half of the newly eligible children who took up public insurance were previously uninsured. The upper bound “crowd-out” rate was estimated to be 46 percent.
The CHIP expansions to children in higher income families were associated with limited uptake of public coverage. Our results additionally suggest that there was crowd-out of private insurance coverage.