Examining Substitution: State Strategies to Limit "Crowd Out" in the Era of Children's Health Insurance Expansions. C. There are various types of data states may need to collect in order to measure substitution.
Most states did not initially identify substitution as a major concern in current efforts to provide coverage to uninsured children. As a result, states did not conduct initial surveys or evaluations to quantify rates of substitution and the long-term impact of employees and employers substituting for private coverage. In order to assist states in