Remember all those claims about how private insurers
would be “crowded out” if Children’s Health Insurance Program income
eligibility guidelines were to be expanded?
Now a report by the National Bureau of Economic Research finds
that those fears are likely to be unfounded as there is little evidence of any
crowd out in the states that have expanded CHIP eligibility.
CCF’s research on this issue
has found that when states raise the income eligibility levels, more children
enroll but the majority of them turn out to be children who already qualified
under the pre-expansion eligibility rules. My colleagues Jocelyn Guyer and Liz Arjun (now with Community Health Plan of Washington) dubbed that the “welcome mat” effect and it has been documented in many states.
Researchers have not yet tackled in detail the question
of why expanding coverage results in many low-income families with
already-eligible children securing coverage, but the primary theories that have
been posited include: increased awareness of coverage opportunities, simplicity
of message, simplification efforts and combating concerns about public
coverage.