Panel Paper: The Impact of the Children’s Health Insurance Program on Supplemental Security Income Program Applications and Awards

Friday, November 3, 2017
Toronto (Hyatt Regency Chicago)

*Names in bold indicate Presenter

Michael Levere, Sean Orzol and Lindsey Leininger, Mathematica Policy Research

This study explores the interplay between two important public programs for vulnerable children: the Supplemental Security Income (SSI) Program and the Children’s Health Insurance Program (CHIP). Specifically, we estimate how the initial creation and continued expansions of CHIP in the late 1990s and early 2000s affected SSI applications and awards among exposed cohorts. We hypothesize that the newly available CHIP coverage – noteworthy for the relative ease of its application process compared with other public programs – was an attractive potential substitute for SSI, especially among families that may have valued SSI primarily for the associated Medicaid benefit. The key data sources for the study are the Current Population Survey and Social Security Administration’s Supplemental Security Record. We use the former to construct measures that reflect the generosity of CHIP eligibility criteria and sociodemographic controls. We use the latter to construct SSI application, award, and appeals counts. We employ a generalized difference-in-differences design that takes advantage of the expansion of CHIP within states over time to isolate plausibly causal impacts of CHIP eligibility on SSI outcomes. Moreover, we explore both the contemporaneous and longer-term effects of CHIP eligibility on SSI program participation, identifying whether and how early exposure to CHIP eligibility changes the trajectory of SSI attachment throughout the course of childhood and early adulthood. Our estimates contribute to the broader literature that examines how the availability of public health insurance options outside of SSI affect SSI applications and enrollment.