The nonpoor uninsured in California, 1998

Health Affairs

Volumn 19, Issue 4, 2000, Pages 171-176

  Yegian, Jill M ^a   Pockell, David G ^a   Smith, Mark D ^a   Murray, Eleanor K ^b  

^a California HealthCare Foundation   (United States)

^b Field Research Corporation   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ADULT; ARTICLE; ATTITUDE TO HEALTH; CLASSIFICATION; COST; ECONOMICS; FEMALE; FINANCIAL MANAGEMENT; HEALTH CARE POLICY; HEALTH SERVICE; HUMAN; INFORMATION PROCESSING; MALE; MIDDLE AGED; PATIENT; SOCIOECONOMICS; STATISTICS; UNITED STATES; UTILIZATION REVIEW;

ADULT; ATTITUDE TO HEALTH; CALIFORNIA; COSTS AND COST ANALYSIS; DATA COLLECTION; FEMALE; FINANCING, PERSONAL; HEALTH POLICY; HEALTH SERVICES; HUMANS; MALE; MEDICALLY UNINSURED; MIDDLE AGED; SOCIOECONOMIC FACTORS;

EID: 0034220534     PISSN: 02782715     EISSN: None     Source Type: Journal    
DOI: 10.1377/hlthaff.19.4.171     Document Type: Article

References (23)

1. D. Chollet, "Consumers, Insurers, and Market Behavior," Journal of Health Politics, Policy and Law (February 2000): 30; E.R. Brown, R. Wyn, and R. Levan, The Uninsured in California: Causes, Consequences, and Solutions (Oakland: California HealthCare Foundation, 1997), 6. In 1998, 200 percent of the federal poverty level was $17,000 for a single person and $33,000 for a family of four.
2. D. Chollet, "Consumers, Insurers, and Market Behavior," Journal of Health Politics, Policy and Law (February 2000): 30; E.R. Brown, R. Wyn, and R. Levan, The Uninsured in California: Causes, Consequences, and Solutions (Oakland: California HealthCare Foundation, 1997), 6. In 1998, 200 percent of the federal poverty level was $17,000 for a single person and $33,000 for a family of four.
3. K. McDonnell and P. Fronstin, eds., EBRI Health Benefits Databook (Washington: Employee Benefit Research Institute, 1999), 61.
4. Chollet, "Consumers, Insurers, and Market Behavior."
5. A. Schneider, K. Fennel, and P. Long, Medicaid Eligibility for Families and Children (Washington: Kaiser Commission on Medicaid and the Uninsured, 1998), 21.
6. We were unable to ascertain, during the short field period, the total number of persons eligible for the survey; thus, potential nonresponse bias does not allow us to make statistical inferences about the nonpoor uninsured population in California. Nevertheless, these interviews provide a rich source of data that describe this population and generate hypotheses about the important factors in the decision making of nonpoor persons with respect to health insurance.
7. These data are publicly available, free of charge, from the archive section of the Web site for the Inter-University Consortium for Political and Social Research (ICPSR), based at the University of Michigan (www.icpsr.umich.edu). Study no. 2688.
8. While the age and employment makeup of the nonpoor uninsured population is similar to that of California's uninsured population overall, the latter is much more likely to be nonwhite (68 percent, compared with 35 percent for the non-poor uninsured). Brown et al., The Uninsured in California, 5-8.
9. These figures are consistent with 1997 national data on the uninsured overall (62 percent excellent/very good and 10 percent fair/poor). Nationally, in terms of health status, the uninsured fall between those with private coverage (73 percent excellent/very good and 6 percent fair/poor) and those with public coverage only (54 percent excellent/very good and 19 percent fair/poor). Authors' calculations based on data in J.P. Vistnes and S.H. Zuvekas, Health Insurance Status of the Civilian Noninstitutionalized Population: 1997, MEPS Research Findings no. 8 (Rockville, Md.: Agency for Health Care Policy and Research, 1999).
10. We also conducted telephone interviews with 802 individually insured California adults with household incomes of at least 200 percent of poverty. In comparison with the nonpoor uninsured, the individually insured were older (forty-two versus thirty-six), less ethnically diverse (79 percent white), more likely to be women (61 percent), and had higher incomes (47 percent versus 24 percent had household incomes of at least 500 percent of poverty). They also were more likely to report excellent or very good health status (75 percent versus 60 percent).
11. Reasons for being ineligible might include parttime or temporary status, or a waiting period between beginning employment and becoming eligible for benefits.
12. The question about perceived cost of premiums was worded: "How much do you think it would cost you to purchase a basic health insurance plan for yourself...Just very roughly, what would be the monthly cost if you wanted health insurance?" The willingness-to-pay question was worded: "How much, if anything, would you be willing to pay each month out of your own pocket for a health insurance plan that provided basic coverage for doctor visits, hospitalization, and prescription drugs for yourself?"
13. For the $10 copayment plan, average premium values used for indexing were as follows: ages 19-29, $80-$90; 30-39, $110-$120; 40-49, $135-$150; 50-59, $160-$185; 60-64, $190-$215. For the $40 copayment plan, average premium values were ages 19-29, $30-$50; 30-39, $45-$75; 40-49, $70-$115; 50-59, $120-$165; 60-64, $145-$205. Average premium ranges for the $2,000 deductible plan were identical to the $40 copayment plan with two exceptions: ages 40-49, $70-$110; and 60-64, $140-$200. The range for each age group is due to variation in premium across geographical regions.
14. C. Swett, "Medical Insurance Rates Go Soaring," Sacramento Bee, 2 June 1999; and "MCOL Releases CA HMO Rate 2000," www.mcol.com/ 041100.htm (13 April 2000).
15. C. Swett, "Medical Insurance Rates Go Soaring," Sacramento Bee, 2 June 1999; and "MCOL Releases CA HMO Rate 2000," www.mcol.com/ 041100.htm (13 April 2000).
16. G.A. Jensen and M.M. Morrisey, "Employer-Sponsored Health Insurance and Mandated Benefit Laws" Milbank Quarterly 77, no. 4 (1999): 425-459.
17. K. Polzer, Retooling Tax Subsidies for Health Coverage: Old Ideas, New Politics, Issue Brief no. 728 (Washington: National Health Policy Forum, 1998); and P. Kilborn, "Help for the Uninsured May Rest in Tax Code," New York Times, 12 March 1999.
18. K. Polzer, Retooling Tax Subsidies for Health Coverage: Old Ideas, New Politics, Issue Brief no. 728 (Washington: National Health Policy Forum, 1998); and P. Kilborn, "Help for the Uninsured May Rest in Tax Code," New York Times, 12 March 1999.
19. See J.M. Yegian, D.P. Pockell, and E.K. Murray, To Buy or Not to Buy (Oakland: California HealthCare Foundation, 1999), 18-21. This report is available online at www.chcf.org/uninsured.
20. See, for example, Health Affairs Spring (II) 1994.
21. D. Kendall, "Getting on the Fast Track to Universal Coverage," Blueprint: Ideas for a New Century (Washington: Democratic Leadership Council, Spring 2000): 24-29; D. Nather, "After Five Years, Reformers Returning to Big Ideas, Not Smaller Steps," BNA's Health Care Policy Report (15 November 1999): 1811-1816; and Polzer, Retooling Tax Subsidies for Health Coverage.
22. D. Kendall, "Getting on the Fast Track to Universal Coverage," Blueprint: Ideas for a New Century (Washington: Democratic Leadership Council, Spring 2000): 24-29; D. Nather, "After Five Years, Reformers Returning to Big Ideas, Not Smaller Steps," BNA's Health Care Policy Report (15 November 1999): 1811-1816; and Polzer, Retooling Tax Subsidies for Health Coverage.
23. D. Kendall, "Getting on the Fast Track to Universal Coverage," Blueprint: Ideas for a New Century (Washington: Democratic Leadership Council, Spring 2000): 24-29; D. Nather, "After Five Years, Reformers Returning to Big Ideas, Not Smaller Steps," BNA's Health Care Policy Report (15 November 1999): 1811-1816; and Polzer, Retooling Tax Subsidies for Health Coverage.