Selden Thomas M, Dubay Lisa, Miller G Edward, Vistnes Jessica, Buettgens Matthew, Kenney Genevieve M
Thomas M. Selden (
Lisa Dubay is a senior fellow in the Health Policy Center at the Urban Institute, in Washington, D.C.
Health Aff (Millwood). 2015 Apr;34(4):697-706. doi: 10.1377/hlthaff.2015.0003.
Millions of US children could lose access to public health care coverage if Congress does not renew federal funding for the Children's Health Insurance Program (CHIP), which is set to expire September 30, 2015—the end of the federal fiscal year. Additional cuts in public coverage for children in families with incomes above 133 percent of the federal poverty level are possible if the Affordable Care Act's "maintenance of effort" provisions regarding Medicaid and CHIP are allowed to expire as scheduled in 2019. The potential for a significant rollback of public coverage for children raises important policy questions regarding alternative pathways to affordable and high-quality coverage for low-income children. For many children at risk of losing eligibility for public coverage, the primary alternative pathway to coverage would be through their parents' employer-sponsored insurance, yet relatively little is known about the cost and quality of that coverage. Our estimates, based on data from the Insurance Component of the 2012 and 2013 Medical Expenditure Panel Surveys, show that many families would face sharply higher costs of covering their children. In many cases, the only employer-sponsored coverage available would be a high-deductible plan.
如果国会不重新为儿童健康保险计划（CHIP）提供联邦资金，数百万美国儿童可能会失去公共医疗保健覆盖。该计划将于2015年9月30日到期，即联邦财政年度结束之时。如果《平价医疗法案》中关于医疗补助和儿童健康保险计划的 “保持努力” 条款按计划于2019年到期，那么收入超过联邦贫困线133% 的家庭中的儿童，其公共保险覆盖范围可能会进一步削减。儿童公共保险覆盖范围大幅缩减的可能性，引发了关于为低收入儿童提供负担得起的高质量保险的替代途径的重要政策问题。对于许多面临失去公共保险资格风险的儿童来说，获得保险的主要替代途径将是通过其父母的雇主提供的保险，然而人们对这种保险的成本和质量了解相对较少。我们根据2012年和2013年医疗支出小组调查保险部分的数据进行的估计表明，许多家庭为子女投保的成本将大幅增加。在许多情况下，唯一可获得的雇主提供的保险将是高免赔额计划。
