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ArnoldView Graph # 1 OVERVIEW Role of Cost-Sharing Experience With Cost-Sharing in Child Health Plus - Premiums - Copayments Assessing Our Cost-Sharing.

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Presentation on theme: "ArnoldView Graph # 1 OVERVIEW Role of Cost-Sharing Experience With Cost-Sharing in Child Health Plus - Premiums - Copayments Assessing Our Cost-Sharing."— Presentation transcript:

1 ArnoldView Graph # 1 OVERVIEW Role of Cost-Sharing Experience With Cost-Sharing in Child Health Plus - Premiums - Copayments Assessing Our Cost-Sharing Choices

2 ArnoldView Graph # 2 Deter Unnecessary Utilization Encourage Personal Responsibility Defray the Cost of the Subsidy Reduce Substitution of Private Coverage ROLE OF COST-SHARING

3 ArnoldView Graph # 3 State Subsidized Health Insurance Program for Children Between 100% and 222% of Poverty Benefits Include Primary and Acute Care Families Are Responsible for Small Premium Contributions and Copayments Health Insurance Is Provided Through Managed Care Plans OVERVIEW OF CHILD HEALTH PLUS

4 ArnoldView Graph # 4 Premium Contributions Copayments EXPERIENCE WITH COST-SHARING IN CHILD HEALTH PLUS

5 ArnoldView Graph # 5 Promote Personal Responsibility Encourage Purchase of Coverage Deter Substitution of Private Coverage Align With Other States Cost-Sharing Requirements DRIVING FACTORS IN SETTING PREMIUM CONTRIBUTIONS

6 ArnoldView Graph # 6 PREMIUM COST-SHARING IN CHILD HEALTH PLUS

7 ArnoldView Graph # 7 Insurers Determine Eligibility and Enroll Families in Child Health Plus Insurers Collect a Monthly Premium Contribution From Families IMPLEMENTATION OF COST-SHARING

8 ArnoldView Graph # 8 CHILDREN ENROLLED IN CHILD HEALTH PLUS

9 ArnoldView Graph # 9 At What Income Level Should Premium Contributions Begin? What Amount of Cost-Sharing Is Both Affordable and Does Not Encourage Crowd-Out? How Should Premium Contributions Be Adjusted for Family Size? ISSUES IN LEGISLATIVE DEBATE ON PREMIUM CONTRIBUTIONS

10 ArnoldView Graph # 10 Most Utilization Control Is Left to the Managed Care Plan Copayments Are Used for Services Only Where Additional Utilization Controls Seem Necessary - Outpatient visits - Prescription drugs - Emergency room visits Implementation of Title XXI Limit on Out-of-Pocket Spending Is Creating Challenges EXPERIENCE WITH COPAYMENTS IN CHILD HEALTH PLUS

11 ArnoldView Graph # 11 Examine Enrollment by Income Level Analyze Utilization by Income Level Assess Reasons for Disenrollment Analyze Extent of Crowd-Out and Reasons for Dropping Private Coverage ASSESSING OUR COST-SHARING CHOICES


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