However, it seems that the Deficit Reduction Act (DRA) (2005) poses a threat to those families who might use Medicaid and SCHIP. Reasons include the imposition of cost sharing, the complications involved in levels of income and percentage of cost demanded, and the need for individual families to keep records that determine what percentage to pay. This is difficult and complicated, as many such families' incomes vary a lot. Research also shows that imposing premiums makes people stop paying or applying for cover. Having such tight budgets already, this represents a further demand on limited resources. Knowing that treatment may be refused if one cannot pay is yet another deterrent. Restrictions on adults without children, enrolment processes, and the lack of knowledge of what is available are other factors preventing both adults and parents taking up insurance for themselves or their children.
Christopher P. Tompkins, Stuart H.