title: Many families may face sharply higher costs if public health insurance for their children is rolled back.
abstract: Millions of US children could lose access to public health care coverage if Congress does not renew federal funding for the Children's Health Insurance Program (CHIP), which is set to expire September 30, 2015—the end of the federal fiscal year. Additional cuts in public coverage for children in families with incomes above 133 percent of the federal poverty level are possible if the Affordable Care Act's "maintenance of effort" provisions regarding Medicaid and CHIP are allowed to expire as scheduled in 2019. The potential for a significant rollback of public coverage for children raises important policy questions regarding alternative pathways to affordable and high-quality coverage for low-income children. For many children at risk of losing eligibility for public coverage, the primary alternative pathway to coverage would be through their parents' employer-sponsored insurance, yet relatively little is known about the cost and quality of that coverage. Our estimates, based on data from the Insurance Component of the 2012 and 2013 Medical Expenditure Panel Surveys, show that many families would face sharply higher costs of covering their children. In many cases, the only employer-sponsored coverage available would be a high-deductible plan.
authors: Thomas M. Selden (Thomas.Selden@ahrq.hhs.gov) is director of the Division of Modeling and Simulation in the Center for Financing, Access, and Cost Trends, Agency for Healthcare Research and Quality (AHRQ), in Rockville, Maryland.
authors: Thomas M
authors: TM
authors: Selden
authors: Lisa Dubay is a senior fellow in the Health Policy Center at the Urban Institute, in Washington, D.C.
authors: Lisa
authors: L
authors: Dubay
authors: G. Edward Miller is a senior economist in the Division of Modeling and Simulation in the Center for Financing, Access, and Cost Trends, at AHRQ.
authors: G Edward
authors: GE
authors: Miller
authors: Jessica Vistnes is a senior economist in the Division of Social and Economic Research in the Center for Financing, Access and Cost Trends, at AHRQ.
authors: Jessica
authors: J
authors: Vistnes
authors: Matthew Buettgens is a senior research associate at the Urban Institute.
authors: Matthew
authors: M
authors: Buettgens
authors: Genevieve M. Kenney is codirector of and a senior fellow in the Health Policy Center at the Urban Institute.
authors: Genevieve M
authors: GM
authors: Kenney
mesh_terms: D002648:Child; D002662:Child Health Services / Q000191:economics* / Q000706:statistics & numerical data; D004608:Eligibility Determination / Q000191:economics; D006297:Health Services Accessibility / Q000191:economics; D006801:Humans; D007348:Insurance, Health / Q000191:economics*; D008484:Medicaid / Q000191:economics*; D010290:Parents; D058991:Patient Protection and Affordable Care Act / Q000331:legislation & jurisprudence*; D014481:United States
keywords: Children < Insurance; Health Reform; Medicaid