Two responses to a premium hike in a program for uninsured kids: 4 in 5 families stay in as enrollment shrinks by a fifth.
This article reports on our study of the effect of premium increases on disenrollment from a health insurance program for low-income immigrant children in Los Angeles County. Two groups of children were compared: those ages 6-18, who were subject to an increase, and those ages 0-5, who were not. Fewer than half of the children in the older group remained enrolled after the premium increase-slightly more than 12,000 children, compared to more than 25,000 at the beginning-and there was a 20 percent decline in overall membership in the program that was attributable to the increase. Although many families paid the higher premium to keep their children enrolled, other families were not able to do so. As programs serving disadvantaged populations contemplate premium increases, we recommend that they tailor specific interventions to children most likely to drop out; establish "hardship funds" to support children with special needs; and link families that may disenroll their children with other programs that could provide coverage or providers who could offer care.
Department of Family Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA. cousinea@usc.edu
Michael R
MR
Cousineau
Kai-Ya
KY
Tsai
Howard A
HA
Kahn
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003625:Data Collection; D054242:Emigrants and Immigrants; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000191:economics* / Q000706:statistics & numerical data*; D015141:Los Angeles; D017057:Medically Uninsured; D011203:Poverty