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Evaluation of Three States’ Reforms to Expand the Availability of Children’s Health Insurance Coverage

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Presentation by Carole Gresenz at the 2009 APPAM conference in Washington, DC, November 5, 2009.

Economy & FinanceBusiness
1 of 14
Evaluation of Three States’ Reforms to Expand the Availability of Children’s Health Insurance Coverage Carole Roan Gresenz (RAND) Sarah Edgington (UCLA) Jos é Escarce (UCLA and RAND) November 2009 Preliminary Results—Not for Citation Funded by SHARE (State Health Access Reform Evaluation), an initiative of the Robert Wood Johnson Foundation
IL, PA and WA Are Among States that Have Led the Way in Expanding Access to Public Health Insurance for Children In 2009, 40 states and DC cover children with family incomes >=200% FPL, compared to only 3 states in 1997. State (Year) Eligible with no premium contribution Eligible with sliding scale premium contribution Eligible with full cost premium contribution Key Restrictions Illinois (2006) <150% FPL 150-400% FPL >400% FPL Pennsylvania (2007) <200% FPL 200-300% FPL >300% FPL Citizens, legal residents & refugees Washington (2007) <200% FPL 200-250% FPL (to be implemented)
Project Uses Mixed-Methods to Study 3 States’ Expansions; Presentation Focuses on Quantitative Analyses ,[object Object],[object Object],[object Object],[object Object],[object Object]
Expansions of Public Coverage to Higher Income Children Have Raised Concerns about “Crowd Out” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Mixed Findings About Crowd Out in Previous Research; Many Analytic Issues ,[object Object],[object Object],[object Object],[object Object]
Approach ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Estimation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Estimation ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Estimation Issues ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Future Analyses ,[object Object],[object Object],[object Object],[object Object]
Preliminary Findings—Effect of Eligibility for Public Insurance on Insurance Status Gold font indicates statistically significant, p<.01 PRELIMINARY RESULTS √ -0.098 -0.082 0.212 Spec 4 √ -0.097 -0.080 0.210 Spec 3 √ √ -0.100 -0.081 0.214 Spec 2 √ √ -0.098 -0.079 0.210 Spec 1 State Unempl. Rate (t-1, t-2) State Unempl. Rate (t, t-1) Private premium (state level) No Ins. Private Public
Preliminary Findings—Effect of Eligibility for Public Insurance on Insurance Status Gold font p<.01; Blue font p<.05, Gray font not significant PRELIMINARY RESULTS -.051 -.053 -.052 -.053 Non Group Private √ -0.098 -.031 0.212 Spec 4 √ -0.097 -.027 0.210 Spec 3 √ √ -0.100 -.030 0.214 Spec 2 √ √ -0.098 -.027 0.210 Spec 1 State Unempl. Rate (t-1, t-2) State Unempl. Rate (t, t-1) Private premium (state level) No Ins. Group Private Public
Conclusions ,[object Object],[object Object],[object Object]
 

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Evaluation of Three States’ Reforms to Expand the Availability of Children’s Health Insurance Coverage

  • 1. Evaluation of Three States’ Reforms to Expand the Availability of Children’s Health Insurance Coverage Carole Roan Gresenz (RAND) Sarah Edgington (UCLA) Jos é Escarce (UCLA and RAND) November 2009 Preliminary Results—Not for Citation Funded by SHARE (State Health Access Reform Evaluation), an initiative of the Robert Wood Johnson Foundation
  • 2. IL, PA and WA Are Among States that Have Led the Way in Expanding Access to Public Health Insurance for Children In 2009, 40 states and DC cover children with family incomes >=200% FPL, compared to only 3 states in 1997. State (Year) Eligible with no premium contribution Eligible with sliding scale premium contribution Eligible with full cost premium contribution Key Restrictions Illinois (2006) <150% FPL 150-400% FPL >400% FPL Pennsylvania (2007) <200% FPL 200-300% FPL >300% FPL Citizens, legal residents & refugees Washington (2007) <200% FPL 200-250% FPL (to be implemented)
  • 3.
  • 4.
  • 5.
  • 6.
  • 7.
  • 8.
  • 9.
  • 10.
  • 11. Preliminary Findings—Effect of Eligibility for Public Insurance on Insurance Status Gold font indicates statistically significant, p<.01 PRELIMINARY RESULTS √ -0.098 -0.082 0.212 Spec 4 √ -0.097 -0.080 0.210 Spec 3 √ √ -0.100 -0.081 0.214 Spec 2 √ √ -0.098 -0.079 0.210 Spec 1 State Unempl. Rate (t-1, t-2) State Unempl. Rate (t, t-1) Private premium (state level) No Ins. Private Public
  • 12. Preliminary Findings—Effect of Eligibility for Public Insurance on Insurance Status Gold font p<.01; Blue font p<.05, Gray font not significant PRELIMINARY RESULTS -.051 -.053 -.052 -.053 Non Group Private √ -0.098 -.031 0.212 Spec 4 √ -0.097 -.027 0.210 Spec 3 √ √ -0.100 -.030 0.214 Spec 2 √ √ -0.098 -.027 0.210 Spec 1 State Unempl. Rate (t-1, t-2) State Unempl. Rate (t, t-1) Private premium (state level) No Ins. Group Private Public
  • 13.
  • 14.  

Editor's Notes

  1. We are studying three expansions of children’s health insurance that were implemented between 2006 and 2007, in Illinois, Pennsylvania, and Washington. The coverage expansions provided health insurance coverage to all kids through SCHIP eligibility expansions and buy-in programs.