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January 2003, Vol 93, No. 1 | American Journal of Public Health 67-74
© 2003 American Public Health Association

HEALTH POLICY AND ETHICS FORUM

What Other Programs Can Teach Us: Increasing Participation in Health Insurance Programs

Dahlia K. Remler, PhD and Sherry A. Glied, PhD

The authors are with the Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY.

Correspondence: Requests for reprints should be sent to Dahlia K. Remler, Department of Health Policy and Management, Mailman School of Public Health, Columbia University, 600 West 168th St, 6th Floor, New York, NY 10032 (e-mail: dr404{at}columbia.edu).

Many uninsured Americans are already eligible for free or low-cost public coverage through Medicaid or Children’s Health Insurance Program (CHIP) but do not "take up" that coverage. However, several other public programs, such as food stamps and unemployment insurance, also have less-than-complete take-up rates, and take-up rates vary considerably among programs.

This article examines the take-up literature across a variety of programs to learn what effects nonfinancial features, such as administrative complexity, have on take-up. We find that making benefit receipt automatic is the most effective means of ensuring high take-up, while there is little evidence that stigma is important.




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