Is Medicaid Responsible for the Erosion of Employer-Based Health Coverage?
End Notes
[1] Cannon was quoted in Julie Rovner, “The Spin Doctors,” CongressDaily AM, Sept. 6, 2006. Also see Michael Cannon, “Op-ed: Medicaid Is Behind the Decline in Private Health Coverage,” Manchester Union Leader, Sept. 19. 2005.
[2] The estimates below do not attempt to simulate all aspects of Medicaid or SCHIP eligibility in each state, which is quite complicated, but instead analyze Current Population Survey data using simplified eligibility criteria in a typical state.
[3] Some childless adults are disabled and therefore could receive Medicaid if they are sufficiently poor, but their disabilities generally would preclude them from working and from employer-sponsored insurance anyway.
[4] Donna Cohen Ross and Laura Cox, “In a Time of Growing Need: State Choices Influence Health Coverage Access for Children and Families,” Kaiser Commission on Medicaid and the Uninsured, Oct. 2005.
[5] Publicly-funded insurance coverage for children is somewhat less restrictive: in the median state, children in families with incomes up to 200 percent of poverty ($33, 200 for a family of three) are eligible for either Medicaid or the State Children’s Health Insurance Program (SCHIP). Children above that level generally are ineligible. Some 3.2 million uninsured children live in families with incomes above 200 percent of the poverty line, based on the Current Population Survey.
[6] For example, see Jack Hadley, “The Effect of Recent Employment Changes and Premium Increases on Adults’ Insurance Coverage,” Medical Care Research and Review, 63(4):447-474, Aug. 2006. Todd Gilmer and Richard Kronick, “It's the Premiums, Stupid: Projections of the Uninsured Through 2013,” Health Affairs Web Exclusive, April 5, 2005.
[7] Two useful reviews are Gestur Davidson, Lynn Blewett and Kathleen Call, “Public Program Crowd-out of Private Coverage: What Are the Issues,” The Synthesis Project, Robert Wood Johnson Foundation, June 2004 and Lisa Dubay, “Expansions in Public Insurance and Crowd Out: What the Evidence Says,” Kaiser Family Foundation, Oct. 1999.
[8] These data are based on CBPP analyses of the CDC’s National Health Interview Survey and the Census Bureau’s Current Population Survey. Because CDC and the Census Bureau differ in how they define and measure insurance coverage and conduct their surveys, they produce somewhat different results.
[9] Jessica Vistnes and Jeffrey Rhoads, “Changes in Children’s Health Insurance Status, 1996-2005: Estimates for the U.S. Civilian Noninstitutionalized Population Under Age 18,” Medical Expenditure Panel Survey Statistical Brief #141, Agency for Healthcare Research and Quality, September 2006. This report examined changes in insurance for children at all income levels, not just low-income children.