Strategies to Prevent Crowd-Out
What Can States Do to Prevent Crowd-Out?
- Institute waiting periods (3, 6, or 12 months).
- Limit eligibility to uninsured or under-insured.
- Subsidize employer-based coverage.
- Impose premium contributions for families above 150 percent of the Federal Poverty Level (FPL).
- Set premiums and coverage at levels comparable to employer-sponsored coverage.
- Monitor crowd-out and implement prevention strategies if crowd-out becomes a problem.
| Strategy* |
States |
| 3-Month Waiting Period |
California, Colorado, Maine, Montana, Utah |
| 6-Month Waiting Period |
Connecticut, Kansas, Maryland, Michigan,
Missouri, Nevada, North Carolina, Oregon, Wisconsin |
| 12-Month Waiting Period |
New Jersey |
| Denial of Coverage if Access to Insurance |
Indiana, Michigan, Minnesota, Rhode Island,
Wisconsin |
| Subsidize Employer Coverage |
Massachusetts, Maryland, New York, North
Carolina |
| Premium Contributions (Above 150 percent FPL) |
Michigan, Rhode Island, North Carolina,
Florida, Georgia, New Jersey, Nevada, California, Kentucky, Massachusetts, New York,
Maine, Colorado, Tennessee, Wisconsin |
*Note: Most States requiring waiting periods
make exceptions under certain conditions.
Challenges States Face in Addressing Crowd-Out
While crowd-out prevention strategies can be effective in reducing or preventing
substitution of public for private coverage, States face several challenges implementing
them. There is concern that crowd-out strategies may:
- Create inequities in the program that reduce participation among the uninsured.
- Be difficult to administer.
- Be difficult to implement given constraints on funds available for crowd-out prevention
in many States.
To overcome these challenges, States will need a delicate balance of policies that will
allow for an adequate focus on crowd-out, given its importance from a budget perspective,
while not drawing attention away from other critical challenges, such as getting uninsured
children to participate in the SCHIP program and providing access to high-quality,
effective medical care in order to realize improvements in child health. Each State
will need to consider the extent to which crowd-out is likely to be a problem given their
program structure and population demographics and utilize that information to develop the
State's crowd-out strategies.
Related
Questions
Give me an overall context
Show me other SCHIP
Workshop presenter-suggested strategies
Tell me some known or potential
problems
Who presented this material?
|
Crowd-Out 
