Issues in Developing Programs for Uninsured Children: A Resource Book for States. A. Overview


States need to consider a number of complex issues as they design cost-sharing requirements for children's health insurance programs. Cost-sharing mechanisms are seen in both public and private programs and are implemented for the following reasons: 1) to reduce the costs associated with providing care; 2) to deter the inappropriate utilization of services (e.g., use of the emergency room for primary health care); 3) to instill a sense of responsibility in participants for their health care; 4) to minimize the welfare stigma associated with public programs; and 5) to prevent the substitution of private insurance. The majority of the study states established cost-sharing requirements in order to instill in their enrollees a sense of responsibility and ownership and to reduce the welfare stigma often associated with public programs.