A U.S. Government Accountability Office director says federal regulators should do more to assess whether public children’s health coverage is substituting for private coverage.
The GAO prepared the report in response to concerns that the State Children’s Health Insurance Program might be crowding out private health insurance. SCHIP critics say crowd-out could affect the ability of the program to reduce the total number of uninsured children.
The GAO looked at the efforts of states and the Centers for Medicare & Medicaid Services, the federal agency that oversees SCHIP and Medicaid, to measure and minimize crowd-out.
“CMS did not collect certain indicators of the potential for crowd-out in SCHIP annual reports, such as the extent to which private health insurance was available and affordable to families,” James Cosgrove, GAO health care director, writes in a report prepared for Sen. Max Baucus, D-Mont., chairman of the Senate Finance Committee.
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“States’ responses to CMS were inconsistent: GAO’s review of annual reports for 2007 found that less than half of the 50 states and the District of Columbia provided a percentage in response to CMS’s question on the percentage of applicants who dropped private health insurance to enroll in SCHIP,” Cosgrove writes.
GAO officials interviewed administrators in 9 states and found that 4 have been making no direct effort to measure crowd-out.
The other 5 have tried to measure crowd-out, “but they all used different methodologies to develop their estimates,” Cosgrove writes.