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Session: Insurance Effects
Room: Elissa Hall
Time: Fri 10:15-11:30

Presenter: Silviya Nikolova (University of Manchester. Health Methodolody Research Group, School of Community Based Medicine)

Abstract

This is the first study to explore the impact of premium variation
across individuals, states, and time on enrollment in the State
Children's Health Insurance Program and their transitions to private
insurance or uninsurance in response to higher premiums. With a
sample of income-eligible children from the Medical Expenditure
Panel Survey, I evaluate the effect of premium
changes on public and private insurance enrollment and uninsurance
using a wide array of methods: Regression-Discontinuity
Design for the study of the within-state variations in premiums,
cross-sectional analysis for evaluating the response using
across-state variation in premiums, and difference-in-differences
strategies that exploit temporal variations in premiums.
The main regression-discontinuity estimates
point to significant declines in public enrollment along with significant
increases in private take-up and no change in the rate of uninsurance.
The cross-sectional results support the finding
that higher premiums are associated with statistically important
decrease in public enrollment and increase in private. I find no evidence
of increases in the rate of uninsurance as a result of public premium increases.
These results are reinforced by the longitudinal findings. They indicate
a statistically significant decline in public enrollment, significant increase
in private and no change in uninsurance for children in the higher-income group
in response to a per dollar increase in premium
over the course of 2003 year.

Key Terms

SCHIP, premium increases, private insurance, uninsurance

Authors:

Silviya Nikolova (University of Manchester. Health Methodolody Research Group, School of Community Based Medicine)

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