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Measuring Adequacy of Coverage for the Privately Insured

New State Estimates to Monitor Trends in Health Insurance Coverage

University of Minnesota, Minneapolis, blewe001{at}umn.edu

Holly Rodin

Blue Cross Blue Shield of Minnesota, Eagan

Gestur Davidson

University of Minnesota, Minneapolis

Michael Davern

University of Minnesota, Minneapolis

The privately insured are assuming a greater share of the costs of their health care, yet little is known about changes in out-of-pocket spending at the state level. The central problem is that national surveys with the relevant data are not designed to generate state-level estimates. The study addresses this shortcoming by using a two-sample modeling approach to estimate state-level measures of out-of-pocket spending relative to income for privately insured adults and children. National data from the Medical Expenditure Panel Survey—Household Component and state representative data from the from the Current Population Survey are used. Variation in out-of-pocket spending over time and across states is shown, highlighting concern about the adequacy of coverage for 2.9% of privately insured children and 7.8% of privately insured adults. Out-of-pocket spending relative to income is an important indicator of access to care and should be monitored at the state level.

Key Words: underinsurance • out-of-pocket spending • insurance • access to care

This version was published on April 1, 2009

Medical Care Research and Review, Vol. 66, No. 2, 167-180 (2009)
DOI: 10.1177/1077558708330426


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