New Study Examines the Impact of Premiums on Enrollment – Say Ahhh! A Children’s Health Policy Blog

In the last year, we’ve examined the potential impact of
proposed premium changes in Florida  and Wisconsin, but a new
study in Health Affairs provides some real-world data on what
actually happens when premiums rise (not that we in any way condone experiments
in children’s coverage of this sort).

Healthy Kids in Los Angeles County is one of a
number of county-run programs in California that were designed to expand
coverage to children who are not eligible for Medicaid or CHIP. While
successful in improving access to care for kids, securing dedicated
funding has been a challenge. As a result, in 2008, the program closed to new
enrollees between the ages of 6 and 18 and in July of 2010, premiums were
increased to $15/child for the older kids that remained in the program.

Before the premium increases, retention rates among these
older kids were high, averaging 98%. However, after the increase, the retention
rate dropped 5 percentage points, mostly in the first two months. At the end of
the study, 59% of those enrolled in June of 2010 were still enrolled, as
opposed to the 80% expected without the premium increase. Meaning, that 4,441
(or 20%) fewer children were enrolled in the program as a result of the

These data confirm what our prior research suggested –
that for many low-income families, even modest increases to premium amounts can
lead them to drop coverage as they struggle to meet other, often competing,
demands on their limited resources.

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