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ABSTRACT

The focus of this study was on the non-price program features that influence the enrollment of non-elderly adults into voluntary state and local programs that subsidize coverage or care.  The study consisted of two phases -- Phase 1 was a literature review to assess the current state of knowledge regarding the impact of non-price design features on enrollment.  Information gathered from this literature was used to inform Phase 2, which consisted of discussions with 67 program directors and other key informants from 17 subsidized coverage programs across the country.  The key findings of the study are as follows:

• There is inadequate knowledge to guide program designers
• Outreach is critical
• A broad spectrum of partnerships is key for creating awareness that leads to enrollment
• Applicants need a high level of insurance counseling and applications assistance
• Program officials need to manage expectations and avoid negative perceptions
• Programs that target adults directly attract enrollment much more easily than programs that involve employers

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Table of Contents

• Executive Summary
• I.  Introduction
• II. Refine Baseline Simulations
• III. Iterative Simulation Approach
• IV. 2006 State of the Union Simulations
• V. Caveats
• VI. Summary
• Appendix: Technical Notes
• Appendix A1: Plan Choice Regression Model (SAS Program Code)
• Appendix A2: Plan Choice Regression Results
• Appendix A3 – HMO Health Care Expenditure Model (SAS Output)
• Appendix A4 – Low Option HRA Health Care Expenditure Model (SAS Output)
• Appendix A5 – High Option HRA Health Care Expenditure Model (SAS Output)
• Appendix A6 – High Option PPO Health Care Expenditure Model (SAS Output)
• Appendix A7 – Medium Option PPO Health Care Expenditure Model (SAS Output)
• Appendix A8 – Low Option PPO Health Care Expenditure Model (SAS Output)

Tables & Figures

• Figure 1
• Table 1: HSA Contributions for Single Coverage, By Age and Income Quartiles
• Table 2:  Comparing MMA Original and New Baseline Populations
• Figure 2: Model of Health Insurance Choices and Costs
• Table 3: Baseline MMA HSA Take-up with Iterative Simulation Component
• Table 4 - Baseline MMA HSA take-up compared to 2006 SOTU Policy Estimate All Three SOTU Options
• Table 5 - Baseline MMA HSA take-up compared to 2006 SOTU Policy Estimate HSA Premium Tax Deductible Option Only
• Table 6 - Baseline MMA HSA take-up compared to 2006 SOTU Policy Estimate
• Table 7 - Baseline MMA HSA take-up compared to 2006 SOTU Policy Estimate
• Table 8 – Summary of SOTU Proposal Impacts
• Figure A1

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Last Updated: 08/14/2009