Uninsured under TennCare: A case study of public health clinic users

Background. We characterized public health clinic users 4 years after imple mentation of a major public health insurance reform and identified barriers to health care access. Methods. We used face-to-face interviews and profile analysis of survey fin dings. Results. The typical public health client household is larger, poorer, and more likely to be black than the wider population. The health status of par ticipants is generally good; the level of insurance coverage is preponderan tly TennCare; and 90% of respondents are willing to pay some premium. Conclusions. Lack of health insurance does not present a serious health car e access barrier, nor do transportation or location; but taking time off fr om work with loss of wages is a problem for those employed. A cost-effectiv e way to enroll uninsured children is to use the County Health Department c linics as a contact point.