Will uninsured people volunteer for voluntary health insurance? Experience from Washington State.
OBJECTIVE
In national and local discussions of health care reform, there is disagreement about whether a national health insurance plan should be mandatory or voluntary. This study describes characteristics of low- income people who were more likely or less likely to be covered by a voluntary plan.


METHODS
Survey data were available from an evaluation of Washington State's Basic Health Plan, which offered subsidized health insurance to low-income residents. For those subjects who were eligible and uninsured at baseline, those who joined were compared with those who did not join on a variety of demographic and health-related characteristics.


RESULTS
There were substantial differences between those who did and did not join the Basic Health Plan. Those who did not enroll were generally less well-off, with less education, lower income, and worse health. Many had never had health insurance.


CONCLUSIONS
If health care reform results in a voluntary plan, additional measures may be needed to ensure that less advantaged citizens have adequate access to health care.
Diehr
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P
Department of Health Services, School of Public Health, University of Washington, Seattle, Washington, USA.
Madden
C W
CW
Cheadle
A
A
Martin
D P
DP
Patrick
D L
DL
Skillman
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D004522:Educational Status; D005191:Family Characteristics; D005260:Female; D006304:Health Status; D006801:Humans; D007182:Income; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D017057:Medically Uninsured / Q000523:psychology / Q000706:statistics & numerical data; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D012959:Socioeconomic Factors; D013221:State Health Plans; D011795:Surveys and Questionnaires; D014481:United States; D014861:Washington