Many Children in CHIP Receive Little or No Care

But the researchers said that policymakers should be careful about raising share-of-costs or premiums for children. In 2008, the median spending level for children enrolled in Medicaid/CHIP for the full year was $226. "This suggests that setting premiums at 'nominal' levels, (say $20 per month per child) could deter some families from enrolling their children in public coverage.

"Indeed, past research indicates that higher public premiums are associated with lower take-up of public programs and higher disenrollment rates, particularly for children with fewer health problems."

Families whose children have no chronic health problems might not view public coverage as cost beneficial, even at fairly low premium levels, they wrote.

The paper was submitted by Genevieve M. Kenney, Joel Ruhter, and Thomas M. Selden. Kenney is a senior fellow at the Urban Institute. Ruhter is a graduate student at the University of Michigan, Ann Arbor. And Tom Selden is an economist with the Agency for Health Research and Quality.