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The effect of premium changes on SCHIP enrollment duration
Jill Boylston Herndon1, W Bruce Vogel, Richard L Bucciarelli
1Department of Epidemiology and Health Policy Research and Institute for Child Health Policy, University of Florida, PO Box 100177, Gainesville, FL 32610-0177, USA.
Health Services Research
|March 29, 2008
Summary
Florida
Area of Science:
- Health Services Research
- Public Health Policy
- Child Health Insurance
Background:
- State Children's Health Insurance Program (SCHIP) provides crucial coverage for low-income children.
- Premium adjustments in public health insurance can impact enrollment and access to care.
- Understanding enrollment duration is key to assessing program stability and effectiveness.
Purpose of the Study:
- To analyze how premium increases in Florida's SCHIP affected children's enrollment duration.
- To investigate differential impacts based on income level and child health status.
Main Methods:
- Utilized administrative and claims data for 153,768 children in Florida's SCHIP (2002-2004).
- Employed accelerated failure time models to assess premium changes ($15-$20/month).
- Controlled for health status and sociodemographic factors, accounting for program transfers.
Main Results:
- Premium hikes significantly shortened enrollment periods, especially for lower-income children (61% decrease).
- Enrollment durations partially recovered but remained affected long-term.
- Children with chronic/acute conditions had longer enrollment and were less sensitive to premium changes.
Conclusions:
- Premium increases disproportionately affected enrollment duration across income and health status groups.
- Even temporary premium changes had lasting impacts, particularly for lower-income families.
- Reversing enrollment declines post-premium increase proved challenging, highlighting policy sensitivity.
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