How Is the Existing Crowd-Out Literature Relevant to SCHIP?
Existing crowd-out literature focuses primarily on the Medicaid expansions for
children and pregnant women. Each of the studies has attempted to answer very
different questions related to crowd-out, therefore it is difficult to use these analyses
to predict crowd-out under SCHIP. Other considerations which make it difficult to predict
crowd-out under SCHIP based on past Medicaid experiences are:
- SCHIP-eligible children have higher incomes than those who were eligible under the
Medicaid expansions.
- SCHIP programs may be different than Medicaid in terms of benefits, providers, and
cost-sharing.
- States are "required" to develop strategies to reduce crowd-out under
SCHIP— this was not a specified provision of past Medicaid expansions.
Although these factors may create differing crowd-out effects under SCHIP, it is still
useful to look to at States’ past experiences with Medicaid expansion programs for
strategies utilized to prevent crowd-out.
Related
Questions
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Where else is HCFA (now CMS) Guidance discussed?
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Crowd-Out 
