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SCHIP premiums, enrollment, and expenditures: a two state, competing risk analysis

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  • James Marton
  • Patricia G. Ketsche
  • Mei Zhou

Abstract

Faced with state budget troubles, policymakers may introduce or increase State Children's Health Insurance Program (SCHIP) premiums for children in the highest program income eligibility categories. In this paper we compare the responses of SCHIP recipients in a state (Kentucky) that introduced SCHIP premiums for the first time at the end of 2003 with the responses of recipients in a state (Georgia) that increased existing SCHIP premiums in mid‐2004. We start with a theoretical examination of how these different policies create different changes to family budget constraints and produce somewhat different financial incentives for recipients. Next we empirically model the impact of these policies using a competing risk approach to differentiate exits due to transfers to other eligibility categories of public coverage from exiting the public health insurance system. In both states we find a short‐run increase in the likelihood that children transfer to lower‐ income eligibility/lower‐premium categories of SCHIP. We also find a short‐run increase in the rate at which children transfer from SCHIP to Medicaid in Kentucky, which is consistent with our theoretical model. These findings have important financial implications for state budgets, as the matching rates and premium levels are different for different eligibility categories of public coverage. Copyright © 2009 John Wiley & Sons, Ltd.

Suggested Citation

  • James Marton & Patricia G. Ketsche & Mei Zhou, 2010. "SCHIP premiums, enrollment, and expenditures: a two state, competing risk analysis," Health Economics, John Wiley & Sons, Ltd., vol. 19(7), pages 772-791, July.
    • Handle: RePEc:wly:hlthec:v:19:y:2010:i:7:p:772-791
    DOI: 10.1002/hec.1514
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    References listed on IDEAS

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    1. Aaron S. Yelowitz, 1995. "The Medicaid Notch, Labor Supply, and Welfare Participation: Evidence from Eligibility Expansions," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 110(4), pages 909-939.
    2. James Marton, 2007. "The impact of the introduction of premiums into a SCHIP program," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 26(2), pages 237-255.
    3. Barbara Wolfe & Scott Scrivner, 2005. "The devil may be in the details: How the characteristics of SCHIP programs affect take-up," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 24(3), pages 499-522.
    4. José Canals-Cerdá & Shiferaw Gurmu, 2007. "Semiparametric competing risks analysis," Econometrics Journal, Royal Economic Society, vol. 10(2), pages 193-215, July.
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    1. James Marton & Angela Snyder & Mei Zhou, 2016. "Enhanced Citizenship Verification And Children'S Medicaid Coverage," Economic Inquiry, Western Economic Association International, vol. 54(3), pages 1670-1683, July.
    2. James Marton & Aaron Yelowitz, 2015. "Health insurance generosity and conditional coverage: Evidence from medicaid managed care in Kentucky," Southern Economic Journal, John Wiley & Sons, vol. 82(2), pages 535-555, October.
    3. Charles J. Courtemanche & James Marton & Aaron Yelowitz, 2019. "Medicaid Coverage across the Income Distribution under the Affordable Care Act," NBER Working Papers 26145, National Bureau of Economic Research, Inc.
    4. Subhasree Basu Roy, 2018. "Effect of Health on Retirement of Older Americans: a Competing Risks Study," Journal of Labor Research, Springer, vol. 39(1), pages 56-98, March.

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