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The Joint Effect of Social Comparison and Social Distance on Evaluation of Intertemporal Choice Outcomes in Event-related Potential Studies

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Published on: August 25, 2023

Revisiting crowd-out update.

Kathleen T Call¹, Lynn A Blewett

¹University of Minnesota School of Public Health.

The Synthesis Project. Research Synthesis Report

|November 5, 2011

Summary

Public insurance can cause individuals to switch from private plans, a phenomenon known as crowd-out. Research shows crowd-out is inevitable with public program expansions, affecting different demographics at varying rates.

Area of Science:

Health economics
Public health policy
Insurance market dynamics

Background:

Crowd-out, the shift from private to public insurance, strains government resources.
Previous research synthesized in 2004 provides a baseline understanding.
This update reviews studies published since 2004.

Purpose of the Study:

To synthesize recent research on crowd-out since 2004.
To quantify crowd-out rates across different populations.
To evaluate the effectiveness of anti-crowd-out measures.

Main Methods:

Literature review of studies published post-2004.
Analysis of crowd-out estimates for various demographic groups.
Examination of policy interventions and their impact on enrollment.

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Published on: January 5, 2018

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Published on: January 5, 2018

Main Results:

Some level of crowd-out is inherent in public insurance expansions.
Crowd-out rates vary: 0-15% for low-income children, 35-50% for higher-income/long-term enrollees.
Anti-crowd-out measures (waiting periods, higher premiums) reduce enrollment.
Crowd-out increases with expanded eligibility to higher incomes/families.
Employer-sponsored insurance (ESI) decline linked more to employee choice than employer action.
Limited evidence suggests public coverage may benefit children more than private insurance.

Conclusions:

Crowd-out is an unavoidable consequence of expanding public insurance.
Targeted strategies are needed to mitigate crowd-out, especially for higher-income groups.
Policy design significantly influences crowd-out effects and overall public health outcomes.