One of the more prominent concerns in the SCHIP reauthorization debate is that many children enrolling in the program could have been insured through their parents' employers. However, concern about parents dropping employer coverage to enroll their children in SCHIP typically ignores the affordability of that coverage. We show that families' spending burden is, on average, lower under public insurance than under employer-sponsored insurance (ESI), especially for the lowest-income families. For families in which children are covered by Medicaid or SCHIP, out-of-pocket spending is, on average, 4 to 5 percent of their income. However, for families in which children have ESI for a full year, the out-of-pocket spending burden is higher, ranging from 12.9 percent of income for families below 150 percent of the federal poverty level (FPL) to 6.1 percent for families between 250-400 percent of FPL.
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