A Low-Cost, Limited-Benefit Policy for the Uninsured: If You Build it, They Will Come

Planning a low-cost ambulatory managed care insurance product for uninsured Los Angeles residents

During 1996 and 1997, the National Health Foundation led a coalition of private sector organizations to test the feasibility of developing a low-cost primary care-only insurance product for uninsured Los Angeles County residents. Project staff conducted:

  • Research on insurance product design.
  • Focus groups with potential consumers.
  • Meetings with health plan representatives, provider groups, and community and small business organizations.

The National Health Foundation, based in Los Angeles, is a nonprofit organization dedicated to improving health care delivery and access.

Key Findings

  • Enrollment in other states' programs was relatively low, except in several highly subsidized programs.
  • Enrollee dollar contributions varied among existing programs because of different subsidy levels, yet benefit structures appeared relatively comprehensive, including some inpatient coverage.
  • Subsidization of individual enrollees was typically based on threshold income levels, with enrollees above 175 percent or 200 percent of the federal poverty level receiving no subsidy.
  • Focus group participants were generally interested in low-cost insurance products, and valued insurance as a concept.
  • Focus group participants generally preferred a full-benefit product, but a low-cost primary care-only insurance product was not rejected and was generally preferred over catastrophic and preventive care products.

Funding

The Robert Wood Johnson Foundation (RWJF) supported this project through a grant of $141,904.

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