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HHIC : Crowd out
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 Crowd-out: has public insurance expansion crowded-out private health insurance?Why important
In 2006, Dr. Jerry Russo and his team at the UH Department of Economics reported findings from the Hawaii Coverage for All Project related to the State Children’s Health Insurance Program (SCHIP) and health insurance coverage in Hawaii. Specifically, the team provided estimates of “crowd out”, in which the growth of enrollment in public programs, specifically SCHIP, would “crowd out” private health insurance.
The existence of “crowd out” has important implications for the cost, efficiency and efficacy of public coverage initiatives and for providers of care. Increasing public insurance while decreasing private insurance is double jeopardy for hospitals. According to HHIC’s DataBank Program, Medicaid/Quest paid 28% below costs in calendar year 2006, while private plans paid 6-22% above costs.
How is Hawaii doing? A recent review of 12 years of HHIC hospital inpatient discharge data for children 0-17, excluding newborns, illustrates “crowd out” in action: a shift away from private insurance coverage in favor of public coverage.
 Data Source HHIC Inpatient Database. To explore the data further, subscribers to HHIC Online Reports® can logon to payer level reports.
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