Describe Crowd-Out in Past Medicaid Expansions

While national estimates of crowd-out have varied significantly across studies according to the methodology employed, the databases used, and the specific question investigated (estimates range from 12 percent to 50 percent), health services research has indicated that the overall extent of crowd-out as a result of past Medicaid expansions has been relatively low:

Of the children who became eligible for Medicaid through expansion programs, the estimated percentage who previously had private insurance coverage and dropped their coverage to enroll in the Medicaid program is between 6 percent and 15 percent (Blumberg, Dubay, and Norton. Survey of Income and Program Participation, 1990).

Evaluations of crowd-out in State-specific children’s health insurance programs conducted in Minnesota and Florida indicated that very few (between 1 percent and 4 percent) of enrollees in the programs previously had private coverage.