Demand for Health Insurance among Uninsured Americans
The 2010 U.S. Patient Protection and Affordable Care Act mandates that citizens obtain health insurance and aims to use state-run health care exchanges to allow the uninsured to purchase more affordable private health care. Prior research on the uninsured has focused on how to increase participation in the traditional employer-based health care system, not on how the uninsured might respond to the opportunity to buy a plan independent of the workplace.
An April 2012 study from Princeton University for the National Bureau of Economic Research, “The Demand for Health Insurance among Uninsured Americans: Results of a Survey Experiment and Implications for Policy,” examined 2008 Gallup poll data that explored how uninsured citizens might take advantage of greater health care coverage opportunities. The scholars analyzed how respondents evaluated coverage at different price points and noted that “to the best of our knowledge, our dataset is the first to elicit self-reported willingness-to-pay for health insurance among a large sample of uninsured Americans.” The study also investigated how the Affordable Care Act’s mandate might expand coverage — and what might happen without a mandate. It assumes, per Congressional Budget Office projections, that there will be 51 million uninsured non-elderly citizens in 2014 without the mandate.
The study’s findings include:
- Some 60% of the uninsured would likely buy comprehensive health insurance for an annual price of $2,000.
- Given the health care subsidies under the Affordable Care Act, 75% of the currently uninsured adult population would likely enroll in a health care plan; this suggests that 39 million Americans would gain coverage.
- Without the health care mandate, roughly 33 million citizens (28 million adults, 5 million children) might gain coverage by taking advantage of provisions in the Affordable Care Act: “Stripping the individual mandate from the law — the constitutionality of which is being challenged in federal court — would lead to between 7 and 12 million fewer individuals gaining coverage.”
- The study also explores concerns that those in poorer health might be more willing to get low-cost insurance, burdening insurers: “We find no evidence that less healthy individuals would be more likely to enroll, with or without a mandate.”
The researchers stated that this more targeted inquiry is “key to formulating a policy” that could extend coverage to the uninsured population: “Not only are these individuals substantially poorer than the average worker offered employer insurance, but the decision to, say, purchase subsidized insurance from a state exchange might fundamentally differ from the decision to enroll in an employer-sponsored health plan, which takes place in the context of co-workers, an employer and potentially benefits counselors.”
Note: One of the paper’s co-authors, Alan B. Krueger, became chairman of the White House Council of Economic Advisers in late 2011.
Tags: health care reform, campaign issue, poverty
Read the issue-related New Yorker article titled "The Mandate Memo: How Obama Changed His Mind."
- What key insights from the study and the magazine article should reporters be aware of as they cover health care reform issues?
- What are the study's key technical term(s)? Which ones need to be put into language a lay audience can understand?
- Do the study’s authors put the research into context and show how they are advancing the state of knowledge about the subject? If so, what did the previous research indicate?
- What is the study’s research method? If there are statistical results, how did the scholars arrive at them?
- Evaluate the study's limitations. (For example, are there weaknesses in the study's data or research design?)
- How could the findings be misreported or misinterpreted by a reporter? In other words, what are the difficulties in conveying the data accurately? Give an example of a faulty headline or story lead.
Newswriting and digital reporting assignments
- Write a lead, headline or nut graph based on the study.
- Spend 60 minutes exploring the issue by accessing sources of information other than the study. Write a lead (or headline or nut graph) based on the study but informed by the new information. Does the new information significantly change what one would write based on the study alone?
- Compose two Twitter messages of 140 characters or fewer accurately conveying the study’s findings to a general audience. Make sure to use appropriate hashtags.
- Choose several key quotations from the study and show how they would be set up and used in a brief blog post.
- Map out the structure for a 60-second video segment about the study. What combination of study findings and visual aids could be used?
- Find pictures and graphics that might run with a story about the study. If appropriate, also find two related videos to embed in an online posting. Be sure to evaluate the credibility and appropriateness of any materials you would aggregate and repurpose.
Class discussion questions
- What is the study’s most important finding?
- Would members of the public intuitively understand the study’s findings? If not, what would be the most effective way to relate them?
- What kinds of knowledgeable sources you would interview to report the study in context?
- How could the study be “localized” and shown to have community implications?
- How might the study be explained through the stories of representative individuals? What kinds of people might a reporter feature to make such a story about the study come alive?
- What sorts of stories might be generated out of secondary information or ideas discussed in the study?