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Crowd out: evidence from the Florida Healthy Kids Program
E Shenkman1, R Bucciarelli, D H Wegener
1Institute for Child Health Policy, University of Florida, Gainesville 32608, USA. eas@ichp.edu
Pediatrics
|September 2, 1999
Summary
Few children had employer-based insurance before enrolling in Florida Healthy Kids. Many families had access to employer coverage, but the cost was a significant burden, indicating some substitution for subsidized plans.
Area of Science:
- Health Services Research
- Pediatric Health Insurance
- Public Health Policy
Background:
- Employer-based family health coverage is a primary source of insurance for children.
- State-subsidized programs aim to increase children's health insurance coverage.
- Concerns exist about substitution of subsidized plans for employer-sponsored coverage.
Purpose of the Study:
- To assess children's insurance coverage prior to state-subsidized program enrollment.
- To determine parental access to employer-based family health coverage.
- To quantify the cost burden of employer-sponsored premiums for families.
Main Methods:
- Telephone interviews conducted with 653 families enrolled in the Florida Healthy Kids Program.
- Data collected on children's insurance status and employer-based coverage access.
- Analysis of the family's share of premium costs relative to income.
Main Results:
- Only 5% of children had employer-based coverage before enrollment.
- 26% of families had access to employer-sponsored family coverage.
- The family premium share averaged 13% of income, varying by income level.
Conclusions:
- Some degree of "crowd out" or substitution of subsidized plans for employer coverage was observed.
- The cost of employer-based coverage presents a significant economic burden for near-poor families.
- Allowing some substitution may be necessary to ensure children obtain needed health insurance.