The Effect of Premiums and Cost Sharing on Access and Outcomes for Low-Income Children

Congress has recently extended funding for the State Children’s Health Insurance Program (CHIP) for two more years through the Medicare Access and CHIP Reauthorization Act of 2015 (P.L. 114-10). 1 By 2017, it will have to consider whether to once again extend funding for the program or permit current law to take effect, sending current CHIP enrollees to other sources of coverage. One issue in the debate will be the level of family financial responsibility, including premiums or enrollment fees, deductibles, copayments, and coinsurance across sources of coverage. In weighing this issue, it is important to consider what we know about how premiums and cost sharing affect low-income children and families. This issue brief examines the literature on the effects of premiums and cost sharing on access and outcomes, particularly for low-income children and their families.