STATE-SPONSORED PROGRAMS FOR THE UNINSURED - IS THERE ADVERSE SELECTION

Risk contracting by states for coverage of previously uninsured popula tions has been hampered by uncertainty regarding likely claims experie nce. This study reports on the utilization experience of two state pro grams offering subsidized coverage in commercial managed care organiza tions to low-income and previously uninsured people. Program participa nts used services similarly to people enrolled through large employer benefit plans. There was no evidence of pent-up demand or an unusual l evel of chronic illness. Similarly, there was little evidence of under utilization, although dissatisfaction and reported barriers to service were more frequent among nonwhite enrollees.