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Crowd-Out Topics Covered

What effect might SCHIP have on "crowding-out" private-sector coverage and how can this be addressed?

The flexible eligibility rules of Title XXI have generated concern regarding the extent to which families may drop private insurance coverage for their children and enroll them in SCHIP, or employers discontinue employee health coverage in response to the availability of SCHIP. This section examines the insights that health services research can provide about the potential "crowd-out" effect of SCHIP on private insurance coverage, drawing on lessons learned from the Medicaid and other public health insurance expansions, as discussed in the September 1998 SCHIP Workshop by Lisa Dubay from the Urban Institute.

To help readers better understand the issue of crowd-out in the era preceding SCHIP, this section contains the following information:

• When Does Crowd-Out Occur?

• Understand Crowd-Out Implications

• What Is the Regulatory Guidance Regarding Crowd-Out Under SCHIP?

• SCHIP Requirements Regarding Medicaid Substitution

• Crowd-Out Effects of Past Medicaid Expansions and Their Implications for SCHIP

• How Is the Existing Crowd-Out Literature Relevant to SCHIP?

• What Are Some Strategies Utilized to Prevent Crowd-Out?

• Crowd-Out References

Total Pages in Section: 8