While cost sharing between the insurer and the insured is an established part of both public and private health insurance in this country, this article notes that it is imperative to use it judiciously in Medicaid and State Children's Health Insurance Programs (SCHIP) to avoid deterring low-income children and families from using needed health care services. The article evaluates past research and new strategies for state programs to consider in their decision-making.

Along with cost sharing charges, families may face other out-of-pocket costs for health care if they need services that are not included in their benefit packages. Given rising health care costs and the budget difficulties facing states, it is likely that Medicaid and SCHIP programs will continue to experiment with changes to their premium and cost sharing policies in the future. The article explains that states will need to continue to balance the challenge that cost sharing poses to low-income families with the need to keep Medicaid and SCHIP costs under control.