Issues in Developing Programs for Uninsured Children: A Resource Book for States. 2. Type of Cost Sharing to be Implemented

03/02/1998

Related to the issue of price sensitivity is the decision whether to implement either a flat fee or a sliding scale premium. While a flat-fee may be administratively appealing, designing a sliding scale premium based on family income may encourage participation. Of the states examined, the Colorado Children’s Health Plan is the only program utilizing a flat enrollment fee. The other eight states have established monthly premiums based on a sliding scale. The Florida Healthy Kids program has a sliding scale based on the three levels of the National School Lunch Program (Free Lunch, Reduced Lunch, and Not on Lunch Program). The seven remaining states have sliding scales based specifically on income.

This section details the strategies used by the nine study states to collect premiums and copayments and the penalties for families that do not pay their monthly premiums.

Table 7: Cost-Sharing Requirements of the Nine State Plans

  CaliforniaKids Colorado Children's Basic Health Plan Florida Healthy Kids MA Children's Medical Security Plan MinnesotaCare New York Child Health Plus Pennsylvania CHIP TennCare Washington Basic Health Plus
Monthly Premiums    

x

x

x

x

x

x

 
Annual Enrollment Fee  

x

             
Copayments

x

x

x

x

 

x

x

 

x

Family Cap