This student project is a critical literature review that examines what it means to be underinsured and the ways of determining the number of people in the United States who are underinsured. The project critically evaluates the typology arguing that it contains various confusions and fails to appreciate the interrelationships that exist between the various aspects of underinsurance. May 2004.

Summary of SHADAC's October 14, 2008 conference call to discuss the recently released model-based Small Area Health Insurance Estimates (SAHIE). This release provides county-level estimates of uninsurance by several demographic characteristics and is based on the Current Population Survey’s Annual Social and Economic Supplement (CPS).

Feldman, R., B. Dowd, S. Leitz and L. A. Blewett. 1997. “The Effect of Premiums on the Small Firms Decision to Offer Health Insurance.” Journal of Human Resources 32: 635-658.

Many small firms (fewer than 50 employees) do not offer health insurance. We investigated the role of premiums in the small firm’s decision to offer health insurance, using data from a 1993 survey of 2,000 small firms in Minnesota. Selectively-corrected equations were estimated to predict the premiums faced by firms offering and not offering insurance. The elasticity of demand .for health insurance, calculated at the mean of the data, was -3.91 for single coverage and -5.82 for family coverage. We contrast these results to the much lower responsiveness found in experimental studies and suggest that our findings are more likely to model the small firm’s demand for health insurance.

Call, K. T., N. Lurie, Y. Jonk, R. Feldman and M. D. Finch. 1997. “Who is Still Uninsured in Minnesota: Lessons from State Reform Efforts.” Journal of the American Medical Association 278 (14): 1191-1195.

OBJECTIVE: To describe Minnesota's health care system reform efforts and their implications for other state and national reform initiatives, document the rate of uninsurance in 1990 and 1995 with special attention to childrens' access to health insurance, and examine the effectiveness of MinnesotaCare, a voluntary state-subsidized health care plan, in serving its target population. DESIGN: Three cross-sectional telephone surveys: 2-stage random samples of Minnesotans of all ages in 1990 and 1995 and a stratified random sample of MinnesotaCare enrollees in 1994. PARTICIPANTS: For the 2 statewide surveys, 10310 respondents participated in 1990 and 11519 in 1995; more detailed information was collected on approximately 1600 respondents in each survey. Eight hundred MinnesotaCare enrollees participated in the third survey conducted in 1994. MAIN OUTCOME MEASURE: Changes in rates of uninsurance. RESULTS: While the rate of uninsurance increased at the national level, the point-in-time Minnesota rate remained stable and low at 6% between 1990 and 1995. The proportion of children uninsured for 12 months or more decreased from 5.2% in 1990 to 3.1% in 1995, while the proportion of uninsured single adults remained stable at approximately 11%. There was no evidence that MinnesotaCare enrollees are gaming the program, or that the program has resulted in significant erosion from the private market. CONCLUSIONS: MinnesotaCare has enabled the state to maintain a low rate of uninsurance and has reduced this rate among its primary target: children. The program has been less effective in enrolling single adults, although it may be too early to witness the effects of recent expansions targeting this group. Minnesota's experience suggests that other state and national reform efforts aimed at reducing uninsurance, particularly among children, are likely to be successful.

Davidoff, M. J. , E. Ulrich, P. Carrizales, and L. A. Blewett. “Improving Health Care Access for Minnesota’s Growing Latino Community” in Just in Time Research: Resilient Communities. Report # BU-7565. Minneapolis: University of Minnesota Hubert H. Humphrey Institute of Public Affairs and University of Minnesota Extension Service.

MinnesotaCare has been a successful policy tool to increase access to health insurance for the uninsured, yet it is not as successful in meeting the unique needs of immigrant communities. This paper presents specific policy recommendations designed to increase access to health care for Latinos in Minnesota and describes the successful collaborative community-based research effort that was used to develop these recommendations.