The Rhode Island Catastrophic Health Insurance Program: The First Three Years

摘要

This is a descriptive analysis of the first three years of operation of a state-sponsored Catastrophic Health Insurance Program (CHIP), initiated by the state of Rhode Island in 1975. Expenses covered by this program are related to family income and existing private insurance coverage. Data derived from the administration of the program and description of recipients of CHIP benefits and data relating to the characteristics of the state's entire population form the basis for this study. The data show that all age-sex groups were represented, but that people over 44 years of age were overrepresented among the CHIP recipients. The data also demonstrated that no income group and no insurance coverage group is immune from catastrophic out-of-pocket expenditures. However, the low-income groups and the uninsured were more likely to qualify for CHIP relative to their proportion in the population. Medical conditions accounting for catastrophic expenditures include dread diseases such as cancer and heart disease. However, other conditions not commonly thought to be catastrophic, such as mental illness, normal delivery, and appendectomy were also included. The inflationary potential of CHIP was explored and it was determined that less than one-half of one percent of total expenditure for the entire state was paid under this program. Further research would permit more accurate consideration of costs of possible national catastrophic programs.