204343 Measures of Underinsurance: Kansas as an Example of State-Level Estimates

Tuesday, November 10, 2009: 9:10 AM

Andrew C. Ward, MPH, PhD , Kansas Health Institute, Topeka, KS
Sharon T. Barfield, MSW, LSCSW , Kansas Health Institute, Topeka, KS
Rachel J. Smit, MPA , Kansas Health Institute, Topeka, KS
In recent years, with the erosion of employer-sponsored health insurance, increased cost sharing by employees in the form of deductibles and co-payments, and the carving out of heretofore offered benefits, many people with health insurance are finding that insurance to be inadequate. These people are not uninsured but instead form the emergent class of people who are underinsured. Whereas a person is either insured or uninsured at a given point of time, characterizing a person as underinsured is not so simple. People can be more or less underinsured, and may be underinsured either because of excessive healthcare costs, or because some needed benefit is not covered by the person's health insurance. Finding metrics that appropriately capture these dimensions of underinsurance has proven challenging, especially when one is interested in state-level estimates. Nevertheless, because many of the remedies for inadequate health insurance coverage require crafting effective and equitable state policies, finding metrics for state-level estimates is important. Using Kansas as an example of what can (and cannot) be estimated, we compare and contrast various extant state-level data sources (e.g., Behavior Risk Factor Surveillance System, the 2001 Kansas HealthWave Survey, the 2001 Kansas Health Insurance Study) to determine which dimensions of underinsurance can be quantified. To assess Kansas relative to the nation as a whole, we compare these estimates to commensurable U.S. estimates from national data sources (e.g., National Health Insurance Survey). We conclude with recommendations about what kind of data collection remains to be done to ensure sound policy creation.

Learning Objectives:
Define quantifiable dimensions of underinsurance. Describe data sources for state-level estimations of rates of underinsurance. Compare state-level estimates of underinsurance for Kansas with commensurable national-level estimates of underinsurance. Discuss the policy implications of the state-level estimates and the next steps needed in data collection.

Keywords: Health Insurance, Survey

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have a Ph.D. and an MPH (Public Health Administration). I presented at the APHA meeting last year (San Diego). I am a senior health policy analyst for the Kansas Health Institute, and was a Post-Doctoral Research Fellow with the Integrated Health Interview Series (IHIS) at the Minnesota Population Center at the University of Minnesota.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.