211406 Problem of public-private crowd-out for insurance surveys

Monday, November 9, 2009: 8:30 AM

Eric Seiber, PhD , College of Public Health, The Ohio State University, Columbus, OH
Crowd-out refers to the degree which expansions of eligibility for public insurance lead individuals to substitute public coverage for private coverage. Many states are considering expanding their public insurance programs to deal with the increasing number of uninsured. As a result of this expansion, enrollment in public insurance programs may grow substantially, which has raised concerns among policy makers about the extent to which public insurance is “crowding out” private insurance.

This presentation will discuss how crowd-out is most commonly measured with survey data. Measurement problems will be covered including the treatment of individuals with multiple sources of coverage and the endogeneity of income based Medicaid eligibility models. The overview of estimation techniques will cover the crowd-out models most used in the policy literature, including two and three stage instrumental variables estimators. The instrumental variables discussion will cover the construction of the most commonly used instruments.

Learning Objectives:
1. Explain the policy implications of public-private crowd-out 2. Describe the statistical techniques for estimating crowd-out 3. Identify the current limitations of these statistical techniques.

Keywords: Health Insurance, Medicaid

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a health economist and have conducted research on the topic of crowd out.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.