The Role of Public and Private Insurance Expansions and Premiums for Low-income Parents

Guy, Gery P.; Johnston, Emily M.; Ketsche, Patricia; Joski, Peter; Adams, E. Kathleen

doi:10.1097/mlr.0000000000000688

Cited by 4 publications

(4 citation statements)

References 25 publications

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“…We report on parental expansions during this time period in a separate article. 46 We test for pre-expansion trends in expanding versus non-expanding states and find no significant differences in the trends for child and parent coverage for the majority of our study states (Appendix Table A2). We use Stata version 14.2 to estimate coefficients, marginal effects, and robust standard errors.…”

Section: Discussionmentioning

confidence: 89%

“…Earlier work indicated states' parental Medicaid expansions increased the likelihood that both parent and child are insured. 46 Whereas children were previously eligible for public coverage when their parents gained eligibility through expansions, able-bodied parents of children who gain eligibility through CHIP expansions are generally not eligible for public coverage. Our study finds CHIP expansions in states where parent and child eligibility levels are within 50 pp increased the probability that parents and children were both insured, driven by a reduction in the likelihood that only the child was insured.…”

Section: Discussionmentioning

confidence: 99%

“…39 The model predicts that higher costs will lower demand for coverage, and if public and private coverage are viewed as substitutes, the costs of each type will affect the take-up of the other type and the probability of uninsurance. [40][41][42][43][44][45][46] Estimates of the marginal employee premiums for family versus individual coverage are highly variable, but an earlier study estimates that for more than half of all workers, they are almost $900 per year, and for the top quartile of all workers, they exceed $2170 per year. 47 We hypothesize that, consistent with prior studies, CHIP expansions increase the probability that children are insured.…”

Section: Conceptual Modelmentioning

confidence: 99%

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Children’s Health Insurance Program Expansions: What Works for Families?

Adams

Johnston

Guy

et al. 2019

Global Pediatric Health

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We examine the impact of Children’s Health Insurance Program (CHIP) eligibility expansions 1999 to 2012 on child and joint parent/child insurance coverage. We use changes in state CHIP income eligibility levels and data from the Current Population Survey Annual Social and Economic Supplement to create child/parent dyads. We use logistic regression to estimate marginal effects of eligibility expansions on coverage in families with incomes below 300% federal poverty level (FPL) and, in turn, 150% to 300% FPL. The latter is the income range most expansions targeted. We find CHIP expansions increased public coverage among children in families 150% to 300% FPL by 2.5 percentage points (pp). We find increased joint parent/child coverage of 2.3 pp ( P = .055) but only in states where the public eligibility levels for parent and child are within 50 pp. In these states, the CHIP expansion increased the probability that both parent/child are publicly insured (2.5 pp) among insured dyads, but where the eligibility levels are further apart (51-150 pp; >150 pp), CHIP expansions increase the probability of mixed coverage—one public, one private—by 0.9 to 1.5 pp. Overall, families made decisions regarding coverage that put the child first but parents took advantage of joint parent/child coverage when eligibility levels were close. Joint public parent/child coverage can have positive care-seeking effects as well as reduced financial burdens for low-income families.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Conceptual Modelmentioning

confidence: 99%

See 1 more Smart Citation

Children’s Health Insurance Program Expansions: What Works for Families?

Adams

Johnston

Guy

et al. 2019

Global Pediatric Health

Self Cite

View full text Add to dashboard Cite

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“…State coverage through Medicaid has been subject to considerably more variation between states as well as temporal changes in eligibility related to state budgets and state policy decisions. Over the past 2 decades, including the 15 years considered in this paper which precedes implementation of the Affordable Care Act states have varied considerably in their approaches to expanding Medicaid [9]. New York and Illinois have implemented extensive coverage expansions prior to the Affordable Care Act, as has Pennsylvania.…”

Section: Discussionmentioning

confidence: 99%

Disparity in breast cancer mortality by age and geography in 10 racially diverse US cities

Sighoko

Hunt

Irizarry

et al. 2018

Cancer Epidemiology

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While the mortality rate for breast cancer is lower among younger women, the NHB:NHW disparities, as measured by rate ratios, are most pronounced in these age groups. Given the absence of available data regarding incidence, stage and subtypes, further research is necessary and such research is important, given the possible policy implications of these results with respect to screening guidelines and coverage for mammography and breast cancer treatment in particular for younger NHB women.

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Effect of Direct-to-Consumer Advertising on Statin Use in the United States

et al. 2017

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Importance The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. Objective We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. Design, setting and participants We conducted an ecological study for 75 designated market areas (DMAs) from 2005 to 2009 in the United States using linked data regarding televised DTCA volume; non-DTCA marketing and promotion; retail, mail order and long-term care prescription drug sales; prescription drug and ambulatory care health care utilization; and contextual factors such as health care density and socioeconomic status. Main outcomes and measures were volume of sales; number of dispensed prescriptions; and high cholesterol-related outpatient visits. Analyses were conducted in 2016. Results The intensity of rosuvastatin and atorvastatin ad exposures per household varied substantially across DMAs. After adjustment for socioeconomic, demographic and clinical characteristics, each 100-unit increase in advertisement viewership was associated with a 2.22% (95% confidence interval [CI] 0.30 to 4.19%) increase in statin sales. Similar patterns were observed between DTCA and statin dispensing among the commercially insured. DTCA was associated with increases in high cholesterol-related outpatient visits among adults 18–45 years of age (3.15% increase in visits per 100-unit increase in viewership, 95% CI: 0.98 to 5.37%) but not among those 46–65 years of age (0.51%, 95% CI: −1.49 to 2.55%). Conclusion DTCA for statins is associated with increases in statin utilization and hyperlipidemia-related outpatient visits, especially for young adults.

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The Role of Public and Private Insurance Expansions and Premiums for Low-income Parents

Cited by 4 publications

References 25 publications

Children’s Health Insurance Program Expansions: What Works for Families?

Children’s Health Insurance Program Expansions: What Works for Families?

Disparity in breast cancer mortality by age and geography in 10 racially diverse US cities

Effect of Direct-to-Consumer Advertising on Statin Use in the United States

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