Medicaid, SCHIP, and Other State Health Care Programs
Available evidence suggests that enrollees in health programs for low-income beneficiaries
(Medicaid, SCHIP, and other state health care programs) can be deterred by very small increases
in premiums or cost sharing. Indeed, some states have increased premiums and copayments, and
others are considering doing the same. Nevertheless, there is meager research for anticipating
how these changes may affect beneficiaries’ decisions to enroll, their use of health services, and
their health outcomes.
Low- and Lower Middle-Income Populations
Many proposals would target assistance to the population whose income is very modest
relative to the average cost of health insurance or health care services, but who are not currently
eligible for public programs. However, designing and evaluating these proposals requires better
information about the price elasticity of demand for insurance among low-income populations, in
order to understand who and how many would participate and how much such assistance would
cost if it were to be effective. Available research evidence clearly indicates that low-income
estimates of price elasticity specifically calculated for the low-income population and the
population from 200 to 400 percent FPL are not generally available.
Mental Health, Dental and Long-Term Care Services
Very few studies have attempted to update or refine the HIE elasticity estimates with respect
to some types of health care services—in particular, the very services for which consumers
historically have had relatively little insurance coverage: mental health care, dental care, and
long-term care services.
Improvements in coverage for these services (e.g., in response to state mental health parity
legislation) have offered some natural experiments demonstrating how consumers respond to 69