Health Affairs

Health Affairs, doi: 10.1377/hlthaff.28.4.w607 (Published online June 2, 2009) © 2009 by Project HOPE	New Online   Getting Health Reform Done   After the State of the Union   Incremental Reform   E-Health in Developing World   Most-Read Articles in 2009

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Cost Sharing In Medicaid And CHIP: How Does It Affect Out-Of-Pocket Spending?

Thomas M. Selden ^1*, Genevieve M. Kenney ², Matthew S. Pantell ³, Joel Ruhter ⁴

¹ Thomas Selden is an economist at the Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality, in Rockville, Maryland.
² Genevieve Kenney is a senior fellow at the Health Policy Center, Urban Institute, in Washington, D.C.
³ Matthew Pantell is a graduate student in the Joint Medical Program, University of California (UC), Berkeley, and UC San Francisco.
⁴ Joel Ruhter is a research associate at the Health Policy Center, Urban Institute.

^*Corresponding author.

Abstract

Rapidly rising spending has prompted debate about increasing cost sharing in Medicaid and the Children's Health Insurance Program (CHIP). In this paper we assess the role of cost sharing in Medicaid and the CHIP and its potential financial burden on low-income families with children. We find that many families would face high health spending burdens even with minimal cost sharing for their publicly insured children. Adding even modest cost sharing for such children could greatly increase high financial burdens. Our results also suggest that implementing income-based caps on family spending can help address the burden of high spending for low-income families. Health Affairs 28, no. 4 (2009): w607-w619 (published online 2 June 2009; 10.1377/hlthaff.28.4.w607)]

Key Words: Access To Care, Business Of Health, Consumer Issues, Health Reform, Insurance - Employer-Based System, Health Spending, Insurance Market, Medicaid, Managed Care - Medicaid, Insurance Coverage

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