Muhlestein David, Seiber Eric
David Muhlestein was a doctoral candidate at The Ohio State University College of Public Health in Columbus, OH, for the bulk of the work done on this study and was with Leavitt Partners in Salt Lake City, UT, for the final work done for the article. Eric Seiber was with The Ohio State University College of Public Health during the time work was done on the study.
Am J Public Health. 2015 Oct;105(10):2021-7. doi: 10.2105/AJPH.2014.302451. Epub 2015 Apr 16.
We estimated changes in children's insurance status (publicly insured, privately insured, or uninsured) and crowd-out rates during the 2007 to 2009 US recession in Ohio.
We conducted an estimate of insurance coverage from statewide, randomized telephone surveys in 2004, 2008, 2010, and 2012. We estimated crowd-out by using regression discontinuity.
From 2004 to 2012, private insurance rates dropped from 67% to 55% and public rates grew from 28% to 40%, with no change in the uninsured rate for children. Despite a 12.0% decline in private coverage and a corresponding 12.6% increase in public coverage, we found no evidence that crowd-out increased during this period.
Children, particularly those with household incomes lower than 400% of the federal poverty level, were enrolled increasingly in public insurance rather than private coverage. Near the Medicaid eligibility threshold, this is not from an increase in crowd-out. An alternative explanation for the increase in public coverage would be the decline in incomes for households with children.
我们估算了2007年至2009年美国经济衰退期间俄亥俄州儿童保险状况（公共保险、私人保险或无保险）的变化以及挤出率。
我们通过对2004年、2008年、2010年和2012年全州范围的随机电话调查来估算保险覆盖情况。我们使用回归断点法估算挤出率。
从2004年到2012年，私人保险率从67%降至55%，公共保险率从28%升至40%，儿童无保险率没有变化。尽管私人保险覆盖率下降了12.0%，公共保险覆盖率相应上升了12.6%，但我们没有发现这一期间挤出率增加的证据。
儿童，尤其是家庭收入低于联邦贫困线400%的儿童，越来越多地加入公共保险而非私人保险。在医疗补助资格门槛附近，这并非由于挤出率增加。公共保险覆盖率上升的另一种解释可能是有孩子家庭的收入下降。
