Cost-sharing for low-income workers: health insurance in the on-your-ownership society

J Health Care Poor Underserved. 2008 Nov;19(4):1229-40. doi: 10.1353/hpu.0.0073.

Abstract

Effects of increased cost-sharing in Washington State's Basic Health Plan (BHP) were assessed among adult BHP beneficiaries (N=14,515) and age-sex-residence matched controls enrolled in Group Health Cooperative. The BHP enrollees had higher disenrollment than controls before and after cost-sharing increases, but disenrollment did not change with increased cost-sharing. Basic Health Plan enrollees' out-of-pocket-costs increased 100% in two years, compared with 42% for controls. Out-of-pocket costs for BHP enrollees with diabetes increased 61% (from $675 to $1,086), while the 90th percentile increased 74%, from $1,358 to $2,365. Basic Health Plan enrollees had somewhat fewer visits than controls after cost-sharing increases, but total costs, timeliness of glucose monitoring, and glycemic control were unaffected. Cost-sharing changes increased out-of-pocket costs for BHP enrollees without affecting total costs, disenrollment, or diabetes quality of care indicators. The predominant effect of increased cost-sharing was to increase costs for low-income workers, particularly those with chronic disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Cost Sharing / economics*
  • Cost Sharing / statistics & numerical data*
  • Diabetes Mellitus / therapy
  • Female
  • Glycated Hemoglobin / analysis
  • Health Expenditures
  • Health Services / statistics & numerical data
  • Humans
  • Insurance, Health / economics*
  • Insurance, Health / statistics & numerical data*
  • Male
  • Middle Aged
  • Poverty / statistics & numerical data*
  • Quality of Health Care / organization & administration
  • State Health Plans / organization & administration
  • Washington

Substances

  • Glycated Hemoglobin A