Study Finds Cuts in Public Health Insurance Eligibility May Shift Billions in Costs to Families, Hospitals

With future funding of public health insurance programs such as Medicaid and the Children’s Health Insurance Program (CHIP) uncertain in the current U.S. political climate, new research in the August 2018 Pediatrics examines how various cuts to eligibility thresholds would affect children. The retrospective cohort study, “The Effect of Lowering Public Insurance Income Limits on Hospitalizations for Low-income Children” (published online July 9), looked at 795,427 hospitalizations of children with public insurance across 14 geographically diverse states. Simulating three different scenarios--eligibility reduced to 300 percent, 200 percent, or 100 percent of the federal poverty limit—researchers determined that at least half of currently covered hospitalizations would become ineligible for public insurance. As a result, costs equaling $1.2, $3.1, and $4.4 billion, respectively, would shift to families who may not be able to afford commercial health insurance, as well to the hospitals serving them and private insurers. The study used the 2014 State Inpatient Databases, which included all hospitalizations for patients age 18 or younger in 14 states, representing 30.6 percent of family households within the United States. While Congress recently re-authorized CHIP funding, the Administration’s 2019 budget proposal includes more than $1 trillion in federal Medicaid cuts over a decade.

Editor’s Note: The solicited commentary, “Cutting Children’s Healthcare Costs,” accompanies this study.

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The American Academy of Pediatrics is an organization of 67,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds