title: Access to Private Coverage for Children Enrolled in CHIP.
abstract: OBJECTIVE
  To provide updated information on the potential substitution of public for private coverage among low-income children by examining the type of coverage held by children before they enrolled in Children's Health Insurance Program (CHIP) and exploring the extent to which children covered by CHIP had access to private coverage while they were enrolled.
  
  
  METHODS
  We conducted a major household telephone survey in 2012 of enrollees and disenrollees in CHIP in 10 states. We used the survey responses and Medicaid/CHIP administrative data to estimate the coverage distribution of all new enrollees in the 12 months before CHIP enrollment and to identify children who may have had access to employer coverage through one of their parents while enrolled in CHIP.
  
  
  RESULTS
  About 13% of new enrollees had any private coverage in the 12 months before enrolling in CHIP, and most were found to have lost that coverage as a result of parental job loss. About 40% of CHIP enrollees had a parent with an employer-sponsored insurance (ESI) policy, but only half reported that the policy could cover the child. Approximately 30% of new enrollees had public coverage during the year before but were uninsured just before enrolling.
  
  
  CONCLUSIONS
  Access to private coverage among CHIP enrollees is relatively limited. Furthermore, even when there is potential access to ESI, affordability is a serious concern for parents, making it possible that many children with access to ESI would remain uninsured in the absence of CHIP.
authors.affiliation: Health Policy Center, Urban Institute, Washington, DC. Electronic address: smcmorrow@urban.org.
authors.forename: Stacey
authors.initials: S
authors.lastname: McMorrow
authors.affiliation: Health Policy Center, Urban Institute, Washington, DC.
authors.forename: Genevieve M
authors.initials: GM
authors.lastname: Kenney
authors.affiliation: Health Policy Center, Urban Institute, Washington, DC.
authors.forename: Timothy
authors.initials: T
authors.lastname: Waidmann
authors.affiliation: Health Policy Center, Urban Institute, Washington, DC.
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Anderson
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D065326:Children's Health Insurance Program / Q000706:statistics & numerical data*; D004608:Eligibility Determination; D005260:Female; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data*; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D007223:Infant; D019458:Insurance Coverage / Q000706:statistics & numerical data*; D007348:Insurance, Health / Q000706:statistics & numerical data; D008297:Male; D011203:Poverty; D011795:Surveys and Questionnaires; D014481:United States
keywords: CHIP; children; crowd out