Children's Health Insurance Program Premiums Adversely Affect Enrollment, Especially Among Lower-Income Children
Children's Health Insurance Program Premiums Adversely Affect Enrollment, Especially Among Lower-Income Children
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DOI：
10.1377/hlthaff.2014.0182
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发表时间：
2014-08-01
期刊：
影响因子：
9.7
通讯作者：
Selden, Thomas M.
中科院分区：
文献类型：
--
作者：
Abdus, Salam;Hudson, Julie;Selden, Thomas M.
医疗补助计划和儿童健康保险计划（CHIP）由各州管理，由联邦和州政府提供资金，为低收入儿童提供健康保险。2013年，33个州在CHIP或医疗补助计划中对某些收入范围的儿童收取保费。利用1999-2010年医疗支出调查的数据，我们发现，保费和保险范围之间的关系因收入水平和父母获得雇主赞助的保险而存在很大差异。在家庭收入超过联邦贫困线150%的儿童中，每月保费增加10美元与医疗补助或CHIP覆盖率减少1.6个百分点有关。在这一收入范围内，父母没有雇主赞助的保险的儿童的无保险增加可能高于父母有雇主赞助的保险的儿童。在家庭收入为贫困人口101%-150%的儿童中，每月保费增加10美元与医疗补助或CHIP覆盖率减少6.7个百分点和无保险增加3.3个百分点有关。在这一收入范围内，父母没有雇主保险的儿童的无保险增加幅度更大。
Both Medicaid and the Children's Health Insurance Program (CHIP), which are run by the states and funded by federal and state dollars, offer health insurance coverage for low-income children. Thirty-three states charged premiums for children at some income ranges in CHIP or Medicaid in 2013. Using data from the 1999-2010 Medical Expenditure Panel Surveys, we show that the relationship between premiums and coverage varies considerably by income level and by parental access to employer-sponsored insurance. Among children with family incomes above 150 percent of the federal poverty level, a $10 increase in monthly premiums is associated with a 1.6-percentage-point reduction in Medicaid or CHIP coverage. In this income range, the increase in uninsurance may be higher among those children whose parents lack an offer of employer-sponsored insurance than among those whose parents have such an offer. Among children with family incomes of 101-150 percent of poverty, a $10 increase in monthly premiums is associated with a 6.7-percentage-point reduction in Medicaid or CHIP coverage and a 3.3-percentage-point increase in uninsurance. In this income range, the increase in uninsurance is even larger among children whose parents lack offers of employer coverage.