State-sponsored Programs for the Uninsured: Is There Adverse Selection?

Authors

Elizabeth Kilbreth PhD, University of Southern Maine, Muskie School of Public Service
Andrew F. Coburn PhD, University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research CenterFollow
Catherine McGuire BS, University of Southern Maine, Muskie School of Public ServiceFollow
Diane P. Martin
Paula Hagedorn Diehr
C. W. Madden
S. M. Skillman

Document Type

Article

Publication Date

1-1-1998

Keywords

Adolescent, Adult, Contract Services, Eligibility Determination, Female, Health Benefit Plans, Employee, Health Services Accessibility, Health Services Research, Humans, Insurance Selection Bias, Maine, Male, Managed Care Programs, Medically Uninsured, Middle Aged, Multivariate Analysis, Patient Satisfaction, Socioeconomic Factors, State Health Plans, United States, Washington

Publication Title

Inquiry : a journal of medical care organization, provision and financing

Abstract

Risk contracting by states for coverage of previously uninsured populations has been hampered by uncertainty regarding likely claims experience. This study reports on the utilization experience of two state programs offering subsidized coverage in commercial managed care organizations to low-income and previously uninsured people. Program participants used services similarly to people enrolled through large employer benefit plans. There was no evidence of pent-up demand or an unusual level of chronic illness. Similarly, there was little evidence of underutilization, although dissatisfaction and reported barriers to service were more frequent among nonwhite enrollees.

Recommended Citation

Kilbreth, E. H., Coburn, A. F., McGuire, C., Martin, D. P., Diehr, P., Madden, C. W., & Skillman, S. M. (1998). State-sponsored programs for the uninsured: Is there adverse selection? Inquiry, 35(3), 250-265.