Implications of Past State Experiences for
Effect of Cost-Sharing on SCHIP
Access and Utilization
In summary, overall lessons learned in States’cost-sharing
experiences were:
- As premiums rise, participation levels fall.
- Even when the program is free, some families will not participate.
- There is no universally "right" level of cost-sharing.
- There are cost-sharing trade-offs between budget and participation goals.
- Cost-sharing should be monitored through a variety of data collection methods, such as
participant surveys and tracking of contributions made and services accessed, in order to
assess the impact of cost-sharing on enrollment and utilization.
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Cost-Sharing 
