The State Children's Health Insurance Program: Participation and Substitution

We examine the effects of SCHIP enactment by focusing on two policy concerns: take-up and crowd-out. The literature has examined how income eligibility expansions affect the type of children's insurance coverage. However, states jointly implemented various policy instruments. The results in previous works do not control for this variety. We analyze how changes in several SCHIP factors affected decisions regarding health insurance coverage. Our analysis indicates that the estimates in the literature may have combined the effects of various policy factors. In distinguishing individual policy factors, our results provide useful information for designing effective public health insurance programs.