American Journal of Public Health
"The Effects of Cost-Shifting in the State Children's Health Insurance Program"
SCHIP programs in most states are available for children who do not qualify for Medicaid and whose families' annual incomes do not exceed 200% of the federal poverty level. However, because of limited funding, some states are increasing premiums, causing some families to discontinue enrollment, the study finds.
Researchers simulated the effects of changes in premiums and enrollment in a community located near the U.S. border with Mexico. Researchers estimated that a $10 increase in monthly premiums would lead to a 10% decline in SCHIP enrollment and a 6% increase in public health costs because children no longer enrolled in the SCHIP program typically used more costly services, such as emergency departments and inpatient services, for routine care.
Although increasing premiums to increase revenue and reduce enrollment in SCHIP might save money, ultimately it can have a substantial effect on use of health services and community health care costs, according to researchers. Reducing enrollment in the program also can result in patients' delaying care, which can lead to large increases in the number of services needed and the intensity of those services to treat a potentially avoidable illness.
The study was conducted by researchers from Rush University of Chicago and Arizona State University (Johnson et al., American Journal of Public Health, April 2006).