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Consequences of SCHIP Expansions for Household Well-Being

In: Frontiers in Health Policy Research, volume 13

Author

Listed:
  • Lindsey Leininger
  • Helen Levy
  • Diane Schanzenbach

Abstract

About 7.4 million children were covered by the State Children's Health Insurance Program (SCHIP) at some point during fiscal year 2008. Many of these children would probably have had private coverage in the absence of SCHIP; recent estimates of the extent of "crowd-out" associated with SCHIP are about 60 percent (Gruber and Simon 2008). The high rate of crowd-out means that the program is not as effective as it could be at reducing the number of uninsured children and has been a political liability for the program. Both political concerns and policy research focusing on crowd-out in SCHIP build on more than a decade of similar attention to the crowd-out associated with the Medicaid expansions of the late 1980s and early 1990s. While there is little doubt that expanding eligibility for public insurance to children who are not poor will lead some to substitute public for private coverage, this substitution should increase total resources available to these households in two ways. First, those who drop private coverage in order to enroll their children in SCHIP can take whatever they had been spending on health insurance and spend it on something else. Second, public insurance requires less cost-sharing than a typical private insurance policy, providing first-dollar coverage with minimal co-payments. This means that switching from private to public coverage reduces a family's out-of-pocket medical spending, freeing up even more of the family's resources for other uses. From the perspective of a low-income family, then, crowd-out is a windfall. In this paper we ask: what do these families do with the additional resources? We address this question with an empirical analysis of consumption data from the Consumer Expenditure Survey. We find that eligibility for SCHIP is associated with an increase in overall expenditure, and most of this increase is allocated to consumption of transportation or saving for retirement. These results suggest that the SCHIP expansion
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Suggested Citation

  • Lindsey Leininger & Helen Levy & Diane Schanzenbach, 2010. "Consequences of SCHIP Expansions for Household Well-Being," NBER Chapters, in: Frontiers in Health Policy Research, volume 13, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberch:12342
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    References listed on IDEAS

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    1. Bruce D. Meyer & James X. Sullivan, 2003. "Measuring the Well-Being of the Poor Using Income and Consumption," NBER Working Papers 9760, National Bureau of Economic Research, Inc.
    2. Shore-Sheppard, Lara & Buchmueller, Thomas C. & Jensen, Gail A., 2000. "Medicaid and crowding out of private insurance: a re-examination using firm level data," Journal of Health Economics, Elsevier, vol. 19(1), pages 61-91, January.
    3. Martin Browning & Annamaria Lusardi, 1996. "Household Saving: Micro Theories and Micro Facts," Journal of Economic Literature, American Economic Association, vol. 34(4), pages 1797-1855, December.
    4. Lo Sasso, Anthony T. & Buchmueller, Thomas C., 2004. "The effect of the state children's health insurance program on health insurance coverage," Journal of Health Economics, Elsevier, vol. 23(5), pages 1059-1082, September.
    5. Diane Whitmore, 2002. "What Are Food Stamps Worth?," Working Papers 847, Princeton University, Department of Economics, Industrial Relations Section..
    6. Dirk Krueger & Fabrizio Perri, 2006. "Does Income Inequality Lead to Consumption Inequality? Evidence and Theory -super-1," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 73(1), pages 163-193.
    7. Herman M. Southworth, 1945. "The Economics of Public Measures to Subsidize Food Consumption," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 27(1), pages 38-66.
    8. Blumberg, Linda J. & Dubay, Lisa & Norton, Stephen A., 2000. "Did the Medicaid expansions for children displace private insurance? An analysis using the SIPP," Journal of Health Economics, Elsevier, vol. 19(1), pages 33-60, January.
    9. Barrow, Lisa & McGranahan, Leslie, 2000. "The Effects of the Earned Income Credit on the Seasonality of Household Expenditures," National Tax Journal, National Tax Association, vol. 53(n. 4), pages 1211-44, December.
    10. Thomas M. Fraker & Alberto P. Martini & James C. Ohls, 1995. "The Effect of Food Stamp Cashout on Food Expenditures: An Assessment of the Findings from Four Demonstrations," Journal of Human Resources, University of Wisconsin Press, vol. 30(4), pages 633-649.
    11. repec:fth:prinin:468 is not listed on IDEAS
    12. Meyer, Bruce D. & Sullivan, James X., 2004. "The effects of welfare and tax reform: the material well-being of single mothers in the 1980s and 1990s," Journal of Public Economics, Elsevier, vol. 88(7-8), pages 1387-1420, July.
    13. Diane Whitmore, 2002. "What Are Food Stamps Worth?," Working Papers 847, Princeton University, Department of Economics, Industrial Relations Section..
    14. Louise Sheiner, 1999. "Health care costs, wages, and aging," Finance and Economics Discussion Series 1999-19, Board of Governors of the Federal Reserve System (U.S.).
    15. Amy Finkelstein, 2007. "The Aggregate Effects of Health Insurance: Evidence from the Introduction of Medicare," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 122(1), pages 1-37.
    16. Bruce D. Meyer & James X. Sullivan, 2008. "Changes in the Consumption, Income, and Well-Being of Single Mother Headed Families," American Economic Review, American Economic Association, vol. 98(5), pages 2221-2241, December.
    17. Barrow, Lisa & McGranahan, Leslie, 2000. "The Effects of the Earned Income Credit on the Seasonality of Household Expenditures," National Tax Journal, National Tax Association;National Tax Journal, vol. 53(4), pages 1211-1244, December.
    18. Busch, Susan H. & Duchovny, Noelia, 2005. "Family coverage expansions: Impact on insurance coverage and health care utilization of parents," Journal of Health Economics, Elsevier, vol. 24(5), pages 876-890, September.
    19. Gruber, Jonathan & Simon, Kosali, 2008. "Crowd-out 10 years later: Have recent public insurance expansions crowded out private health insurance?," Journal of Health Economics, Elsevier, vol. 27(2), pages 201-217, March.
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    Cited by:

    1. Bhashkar Mazumder & Sarah Miller, 2014. "The Effects of the Massachusetts Health Reform on Financial Distress," Working Paper Series WP-2014-1, Federal Reserve Bank of Chicago.
    2. Qureshi, Javaeria A. & Gangopadhyaya, Anuj, 2021. "Childhood Medicaid Eligibility and Human Capital," Economics of Education Review, Elsevier, vol. 82(C).
    3. Lipton, Brandy, 2019. "Adult Medicaid Benefit Generosity and Receipt of Recommended Health Services among Low-Income Children: The Spillover Effects of Medicaid Adult Dental Coverage Expansions," MPRA Paper 93248, University Library of Munich, Germany.
    4. Dhaval M. Dave & Robert Kaestner & George L. Wehby, 2019. "Does public insurance coverage for pregnant women affect prenatal health behaviors?," Journal of Population Economics, Springer;European Society for Population Economics, vol. 32(2), pages 419-453, April.
    5. Boudreaux, Michel H. & Golberstein, Ezra & McAlpine, Donna D., 2016. "The long-term impacts of Medicaid exposure in early childhood: Evidence from the program's origin," Journal of Health Economics, Elsevier, vol. 45(C), pages 161-175.
    6. Alan Monheit & Jessica Vistnes, 2015. "Does Public Health Insurance for Children Improve Single Mothers’ Health Care Use?," Journal of Family and Economic Issues, Springer, vol. 36(4), pages 581-592, December.
    7. Lucie Schmidt & Lara Shore-Sheppard & Tara Watson, 2016. "The Effect of Safety-Net Programs on Food Insecurity," Journal of Human Resources, University of Wisconsin Press, vol. 51(3), pages 589-614.
    8. Dahl, Gordon B. & Forbes, Silke J., 2023. "Doctor switching costs," Journal of Public Economics, Elsevier, vol. 221(C).
    9. Kofinti, Raymond Elikplim & Koomson, Isaac & Paintsil, Jones Arkoh & Ameyaw, Edward Kwabena, 2022. "Reducing children's malnutrition by increasing mothers' health insurance coverage: A focus on stunting and underweight across 32 sub-Saharan African countries," Economic Modelling, Elsevier, vol. 117(C).
    10. Panchalingam, Thadchaigeni, 2020. "Effects of Public Health Insurance Expansions on Consumption Expenditures of Targeted Households," 2020 Annual Meeting, July 26-28, Kansas City, Missouri 304513, Agricultural and Applied Economics Association.
    11. repec:mrr:papers:wp341 is not listed on IDEAS
    12. Michael Manville & Brian D. Taylor & Evelyn Blumenberg & Andrew Schouten, 2023. "Vehicle access and falling transit ridership: evidence from Southern California," Transportation, Springer, vol. 50(1), pages 303-329, February.
    13. Lipton, Brandy J., 2021. "Adult Medicaid benefit generosity and receipt of recommended health services among low-income children: The spillover effects of Medicaid adult dental coverage expansions," Journal of Health Economics, Elsevier, vol. 75(C).
    14. Bronchetti, Erin Todd, 2014. "Public insurance expansions and the health of immigrant and native children," Journal of Public Economics, Elsevier, vol. 120(C), pages 205-219.
    15. Noghanibehambari, Hamid, 2022. "Intergenerational health effects of Medicaid," Economics & Human Biology, Elsevier, vol. 45(C).

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