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AJPH First Look, published online ahead of print Feb 28, 2006
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AJPH.2004.059758v1
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April 2006, Vol 96, No. 4 | American Journal of Public Health 709-715
© 2006 American Public Health Association
DOI: 10.2105/AJPH.2004.059758


RESEARCH AND PRACTICE

The Effects of Cost-Shifting in the State Children’s Heath Insurance Program

Tricia J. Johnson, PhD, Mary Rimsza, MD and William G. Johnson, PhD

Tricia J. Johnson is with the Department of Health Systems Management, Rush University, Chicago, Ill. Mary Rimsza and William G. Johnson are with the School of Health Management and Policy, W. P. Carey School of Business, Arizona State University, Tempe, Ariz.

Correspondence: Requests for reprints should be sent to Tricia J. Johnson, PhD, Dept of Health Systems Management, Rush University, TOB Suite 126B, Chicago, IL 60612 (e-mail: tricia_j_johnson{at}rush.edu).

Objectives. Many states are increasing the State Children’s Health Insurance Program (SCHIP) cost-sharing requirements to induce reductions in enrollment. We examined the effect of increasing SCHIP premiums on both health care use and cost to the public.

Methods. The net cost to the public of increased cost sharing for SCHIP-insured children in a border community was estimated with multivariate methods. The majority (88%) of children were of Mexican origin.

Results. We estimated that a $10 increase in monthly premiums would induce 10% of SCHIP children to disenroll, resulting in a 6% increase in public expenditures.

Conclusions. Families that disenroll from SCHIP and become uninsured typically turn to emergency departments for primary care, which increases total health care expenditures through the use of more expensive services.




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M. E. Rimsza, R. J. Butler, and W. G. Johnson
Impact of Medicaid Disenrollment on Health Care Use and Cost
Pediatrics, May 1, 2007; 119(5): e1026 - e1032.
[Abstract] [Full Text] [PDF]




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