gross income of $32,100 for a family of four. The legislation allowed an exception to this eligibility requirement for states that as of June 1997 provided Medicaid to children with family incomes above 150 percent of poverty. Those states may use SCHIP funds to cover children whose family incomes are above 200 percent of poverty, up to 50 percentage points above the state's Medicaid eligibility level.

When you think about the crowd-out issue, you have to look at the parents' insurance status. What you see is that parents don't have insurance and they delay their own care, because they are busy taking care of their children. Forty-six percent of our children were uninsured for six or more months. That is an important thing to factor into this question. If they have been uninsured for six months, they didn't come into our program from some other source of coverage. And 12 months later, only 61 percent of our kids were still in our program. So we're not here building a generational entitlement program.

Charles LaVallee

Western Pennsylvania Caring Program for Children, Pittsburgh, PA

Public Workshop, June 2, 1997

There has been a lot of talk about crowd-out, but there is very limited evidence that at the lowest end of the income spectrum, you are crowding out private insurance. Private insurance largely does not exist for the parents in these working families.

Diane Rowland

Kaiser Commission on the Future of Medicaid, Washington, DC

Public Workshop, June 2, 1997

There is a lot of pressure and debate on the question of when public coverage should let off and when private coverage should begin. Where is that transition area in which you might be providing some public subsidy, but not a full public subsidy? It's a gray area, and there is going to be heavy debate about where the cut-off point should be.

Kay Johnson

George Washington University, Washington, DC

Public Workshop, June 2, 1997

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