Table 2.
Participants in Higher Cost-Sharing Levels by Income/Subsidy Categories
| Service and Cost Sharing, $ | Participants, %a | |||||
|---|---|---|---|---|---|---|
| Subsidized | Unsubsidized | Total | ||||
| Medicaid (≤100% of the FPL) | CHIP (101%–250% of the FPL) | ≤250% of the FPL | 251%–400% of the FPL | >400% of the FPL | ||
| Brand drugs | ||||||
| ≤20 | 100 | 100 | 61.2 | 70.1 | 60.0 | 71.3 |
| ≥25 | 0 | 0 | 38.9 | 29.9 | 40.1 | 28.7 |
| Office visits | ||||||
| ≤15 | 100 | 100 | 67.5 | 64.2 | 53.0 | 70.2 |
| ≥20 | 0 | 0 | 32.5 | 35.8 | 47.0 | 29.9 |
| ED visits | ||||||
| ≤50 | 100 | 100 | 60.6 | 60.4 | 61.9 | 70.6 |
| ≥75 | 0 | 0 | 39.4 | 39.6 | 38.1 | 29.4 |
| All services at all high levels | 0 | 0 | 24.2 | 21.1 | 25.9 | 18.2 |
Abbreviations: CHIP, Children’s Health Insurance Program; ED, emergency department; FPL, federal poverty level.
a
Weighted for sampling proportions; participants with deductibles for the relevant service or all services were included in the higher cost-sharing level (3.6% had deductibles that applied to all services; 9.9%, to hospital services and ED visits only; and 3.0%, to prescription drugs). Income limits for Medicaid and CHIP are for children and adolescents aged 6 to 18 years.