How Changing Financial Barriers to Health Insurance Affects Coverage and Worker Morale

Increasing health insurance coverage for low-income employees
    • September 19, 2003

During 2000 and 2001, Catholic Health East established the Affordable Access Initiative to increase the participation of its low-income employees in employer-sponsored health insurance coverage.

Project staff completed an economic analysis and interviewed affiliated institutions to learn about "best practices" used to facilitate increased employee enrollment.

Catholic Health East is a multi-institutional health system located in 11 eastern states.

Key Findings

Key findings from the Affordable Access study are as follows:

  • Price is the single greatest barrier to enrolling low-income workers in employer-sponsored health insurance.
  • Price, however, is not the only influence on health insurance participation rates; other factors, such as the availability of substitute forms of care (e.g., the emergency room), also affect demand.
  • Employer price subsidies must be large, relative to the price of health insurance, for low- and moderate-income workers to purchase coverage.
  • Catholic Health East would have to pay slightly more than $1 million to increase insurance enrollment rates for its low-income workers to the level of those earning more that $20,000 (where a 75.7% enrollment rate has been achieved).
  • Communication and outreach are important to the goal of increasing employee enrollment in health insurance programs.