Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Oct;47(5):1999-2011.
doi: 10.1111/j.1475-6773.2012.01408.x. Epub 2012 Apr 19.

Take-up of public insurance and crowd-out of private insurance under recent CHIP expansions to higher income children

Carole Roan Gresenz  1 , Sarah E Edgington, Miriam Laugesen, José J Escarce
Affiliations

Take-up of public insurance and crowd-out of private insurance under recent CHIP expansions to higher income children

Carole Roan Gresenz et al. Health Serv Res. 2012 Oct.

Abstract

Objective: 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.

Data sources: 2002-2009 Current Population Survey linked to multiple secondary data sources.

Study design: 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.

Principal findings: 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.

Conclusions: 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.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Changes in CHIP Maximum Income Eligibility Thresholds among Expansion States: 2002–2009
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. TRIM3 project website. [accessed on October 26, 2011]. Available at http://trim3.urban.org.
    1. Bansak C, Raphael S. “The Effects of State Policy Design Features on Take-up and Crowd-out Rates for the State Children's Health Insurance Program”. Journal of Policy Analysis and Management. 26(1):149–75. - PubMed
    1. Bissell MK, Allen M. Healthy Ties: Ensuring Health Coverage for Children Raised by Grandparents and Other Relatives. Washington, DC: Children's Defense Fund; [accessed November 15, 2010]. Available at http://cdf.childrensdefense.org/site/DocServer/healthyties_fullreport.pd....
    1. Cutler DM, Gruber J. “Does Public Insurance Crowd Out Private Insurance?”. Quarterly Journal of Economics. 2006;111(2):391–430.
    1. Davern M, Jonese A, Lepkowski J, Davidson G, Blewett LA. “Estimating Regression Standard Errors with Data from the Current Population Survey's Public Use File”. Inquiry. 1996;44(2):211–24. May. - PubMed

Publication types