Children's health insurance: The difference policy choices make

This paper provides estimates of the cost and coverage impacts of the new S tate Children's Health Insurance Program (SCHIP). The estimates reflect the many choices the states are given by the legislation: whether to use tradi tional Medicaid or establish separate state-run programs; how far to extend eligibility up the income distribution; and how much to use premiums. We e stimate the impacts of these choices on participation by the uninsured as w ell as by the insured-that is, the crowd-out effect-and on public expenditu res. We also estimate the savings to families and firms that substitute SCH IP for private coverage. We conclude with estimates of the cost and coverag e impacts of the actual initial choices that states have made.