State-sponsored programs for the uninsured: is there adverse selection?
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.
Kilbreth
E H
EH
Institute for Health Policy, Edmund S. Muskie School of Public Service, University of Southern Maine, Portland 04104-9300, USA.
Coburn
A F
AF
McGuire
C
C
Martin
D P
DP
Diehr
P
P
Madden
C W
CW
Skillman
S M
SM
D000293:Adolescent; D000328:Adult; D003284:Contract Services / Q000706:statistics & numerical data*; D004608:Eligibility Determination; D005260:Female; D006264:Health Benefit Plans, Employee / Q000706:statistics & numerical data; D006297:Health Services Accessibility / Q000592:standards; D006302:Health Services Research; D006801:Humans; D015273:Insurance Selection Bias; D008281:Maine; D008297:Male; D008329:Managed Care Programs / Q000706:statistics & numerical data*; D017057:Medically Uninsured; D008875:Middle Aged; D015999:Multivariate Analysis; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D012959:Socioeconomic Factors; D013221:State Health Plans / Q000706:statistics & numerical data*; D014481:United States; D014861:Washington