A new report by researchers at The Ohio State University College of Public Health finds that wealthier families who are eligible for public insurance are less likely to switch from private to public coverage than families earning less. The authors use ACS data and a regression discontinuity approach to obtain state estimates on how many children near the state Medicaid/CHIP threshold are crowded-out of private insurance.

The primary finding is that there is a lot of variation between states’ crowd-out at specific eligibility thresholds. (The regression discontinuity approach shows a localized effect—it only allows for crowd-out estimates for children who were right around the eligibility threshold.) Of the 19 states that have a 200% FPL eligibility threshold, only 5 had statistically significant crowd-out estimates (ranging from 6.9% to 10.61%). Of the 8 states that use 250% FPL as their threshold, only California had a statistically significant crowd-out estimate (3.27%). Finally, there were no statistically significant estimates of crowd-out for states that use 300% FPL as their eligibility threshold. These findings cast doubt on the common idea that crowd-out is higher for children at higher income levels.

The crowd-out estimates are relatively small at all income levels, so concerns about them seem unfounded. The results suggest that the majority of children from families with higher incomes who have Medicaid do so because their parents lack private insurance. We shouldn’t allow misplaced concerns about crowd out to create false barriers between kids and coverage.