ERIC Number: ED477628
Record Type: Non-Journal
Publication Date: 2003-May
Reference Count: N/A
Premium Assistance Programs under SCHIP: Not for the Faint of Heart. Assessing the New Federalism: An Urban Institute Program To Assess Changing Social Policies. Occasional Paper.
Lutzky, Amy Westpfahl; Hill, Ian
Under the State Childrens Health Insurance Program (SCHIP), states have the option to subsidize employer premiums for low-income workers with children. Given the potential for subsidized employer-sponsored insurance (ESI) programs to reduce the number of uninsured children, this study examined SCHIPs regulations and state experiences with premium assistance programs. In addition to a literature review, three states, Massachusetts, Mississippi, and Wisconsin, were selected for in-depth examination. Data were collected through telephone interviews with officials from each state and from the Centers for Medicare and Medicaid Services regarding the impact of SCHIP regulations, state implementation experiences, and lessons learned. Findings revealed that although state officials viewed premium assistance as a worthwhile means of expanding health coverage, the experiences of Massachusetts and Wisconsin suggest that subsidizing ESI programs is administratively complex due to federal requirements addressing concerns about crowd out--the potential that SCHIP might displace private insurance coverage. These states found that outreach efforts had to be augmented with specific efforts targeting employers. Enrollment procedures were complex, time-consuming, and challenging, especially the requirements to compare employee benefit packages to the state-selected SCHIP benchmark. Massachusetts and Wisconsin officials cautioned other states from being overly optimistic about initial enrollment, with Wisconsins enrollment currently at 47 families. Mississippi had yet to implement its program, but state officials were optimistic that it is a worthwhile strategy within the broader context of expanding health coverage. It was concluded that it is reasonable for states to question the efficiency of this strategy for reducing the number of uninsured among low-income children, given the limited target population and the small likelihood that federal regulations for premium assistance under SCHIP will be relaxed. (Contains 25 endnotes and 24 references.) (KB)
Descriptors: Child Health, Children, Fringe Benefits, Health Insurance, Program Implementation, Public Policy, State Federal Aid, State Programs
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Publication Type: Reports - Evaluative
Education Level: N/A
Sponsor: Annie E. Casey Foundation, Baltimore, MD.; Robert Wood Johnson Foundation, New Brunswick, NJ.; Kellogg Foundation, Battle Creek, MI.; John D. and Catherine T. MacArthur Foundation, Chicago, IL.; Ford Foundation, New York, NY.; Office of the Assistant Secretary for Planning and Evaluation (DHHS), Washington, DC.
Authoring Institution: Urban Inst., Washington, DC.
Identifiers - Laws, Policies, & Programs: Childrens Health Insurance Program