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ERIC Number: EJ759388
Record Type: Journal
Publication Date: 2007
Pages: 27
Abstractor: Author
Reference Count: N/A
ISSN: ISSN-0276-8739
The Effects of State Policy Design Features on Take-Up and Crowd-Out Rates for the Sate Children's Health Insurance Program
Bansak, Cynthia; Raphael, Steven
Journal of Policy Analysis and Management, v26 n1 p149-175 Win 2007
We evaluate the effects of state policy design features on SCHIP take-up rates and on the degree to which SCHIP benefits crowd out private benefits. The results indicate overall program take-up rates of approximately 10 percent. However, there is considerable heterogeneity across states, suggesting a potential role of inter-state variation in policy design. We find that several design mechanisms have significant and substantial positive effects on take-up. For example, eliminating asset tests, offering continuous coverage, simplifying the application and renewal processes, and extending benefits to parents all have sizable and positive effects on take-up rates. Mandatory waiting periods, on the other hand, consistently reduce take-up rates. In all, inter-state differences in outreach and anti-crowd-out efforts explain roughly one-quarter of the cross-state variation in take-up rates. Concerning the crowding out of private health insurance benefits, we find that between one-quarter and one-third of the increase in public health insurance coverage for SCHIP-eligible children is offset by a decline in private health coverage. We find little evidence that the policy-induced variation in take-up is associated with a significant degree of crowd out, and no evidence that the negative effect on private coverage caused by state policy choices is any greater than the overall crowding-out effect. This suggests that states are not augmenting take-up rates by enrolling children that are relatively more likely to have private health insurance benefits.
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Publication Type: Journal Articles; Reports - Evaluative
Education Level: N/A
Audience: Policymakers
Language: English
Sponsor: N/A
Authoring Institution: N/A
Identifiers - Laws, Policies, & Programs: Childrens Health Insurance Program