Changes in use of health services by the uninsured, when covered after
health reform, are a key to the costs of reform. From data on persons
under age sixty-five in the 1989 National Health Interview Survey, we
estimated their expected use of hospitals (excluding obstetric delive
ries) and doctor visits, adjusting for age, sex, and self-reported hea
lth status. If uninsured persons obtained private coverage distributed
by the plan type of other persons in their home regions, nonobstetric
hospital days for the formerly uninsured would increase 28 percent, a
nd their visits to physicians' offices would increase 52 percent. If i
nstead the uninsured enrolled entirely in group- or staff-model health
maintenance organizations (HMOs) in their home regions, their nonobst
etric hospital days would actually decrease 17 percent, and their visi
ts to physicians' offices would increase 60 percent.