To evaluate the effect of the Oregon and New Mexico Health Insurance Flexibility and Accountability () demonstrations. is an optional state Medicaid expansion targeted at adults and children with incomes below 200 percent of the federal poverty level (). The study has five research questions: What type of health insurance do enrollees self report in surveys? What are the demographic characteristics of these enrollees? What type of health insurance coverage, if any, did enrollees have just prior to enrollment in the program? Among those with prior coverage, what prompted participation in the program? What type of health insurance, if any, would enrollees have in the absence of ?
Data were collected via telephone interviews with a total of 406 enrollees from Oregon and 409 enrollees from New Mexico. The survey was conducted between July 7 and September 20, 2009, for both states. The sample frame for the survey was based on administrative records of adults enrolled in June 2009. After completion of the survey, active enrollment status as of the date the telephone interview was confirmed. Respondents no longer enrolled at the time of the survey (7 cases in and 14 in ) were excluded from the analysis. The final sample size was 794 verified enrollees.
enrollees tended to be middle‐aged, male, and relatively unhealthy. Employment status varied tremendously from the self‐employed to retired to unable to work. enrollees were reasonably well educated with 80 percent having at least a high school education. Most enrollees (90 percent) reported being uninsured just prior to participation in . Of those who were uninsured, most reported having been uninsured for an extended time—a year or more. Most enrollees joined because they lacked access to health insurance or could not afford insurance on the private market. The overwhelming majority (76 percent) of respondents believed that they would be uninsured in the absence of , with few considering either an employer plan or private purchase to be a viable option. Over 90 percent of enrollees correctly indicated they had insurance coverage. However, characterization of the type of coverage was problematic, particularly in the absence of the program‐specific name.
enrolled a relatively sick, male, middle‐aged population that tended to have been long‐term uninsured—the kind of enrollees for which the programs were designed—with little apparent crowd‐out of private insurance. The reported health status coupled with low incomes suggests that individual purchase is unlikely, a sentiment echoed by the respondents. In the absence of , most enrollees believed they would rejoin the ranks of the uninsured from where they came.
