What Can the Take-Up of Other Programs Teach Us About How to Improve Take-Up of Health Insurance Programs?

Abstract

Many uninsured Americans are already eligible for free or low-cost public coverage through Medicaid or CHIP but do not take up that coverage. Several other programs, such as food stamps and unemployment insurance, also have less than complete take-up rates and take-up rates vary considerably among programs. This paper examines the take-up literature across a variety of programs to learn what effects non-financial features, such as administrative complexity, have on take-up. We find that making benefit receipt automatic is the most effective means of ensuring high take-up, while there is little evidence that stigma is important. Overall, surprisingly little is known about the quantitative impact, of non-financial characteristics of programs on take-up. New research that could be used to draw measurable causal inferences about how features as administrative complexity, renewal rules, and organizational structure affect participation, would be extremely valuable.