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The Resilience of the Health Care Safety Net, 1996-2001

Feb. 21, 2003
Health Services Research, 38:1, Part II (February 2003), pp. 489-502
Laurie E. Felland, Cara S. Lesser, Andrea Staiti, Aaron Katz, Patricia Lichiello

The safety net in the three-quarters of the communities was stable or improved by the end of the study period, leading to improved access to primary and preventive care for the low-income uninsured. Policy responses to pressures such as the Balanced Budget Act and Medicaid managed care, along with effective safety net strategies and supportive conditions helped reinforce the safety net. However, the safety net in three sites deteriorated and access to specialty services remained inadequate across the 12 sites.

Despite pessimistic predictions and some notable exceptions, the health care safety net grew stronger over the past six years. Given considerable community variation, however, this analysis indicates that policymakers can apply a number of lessons from strong and improving safety nets to strengthen those that are weaker, particularly as the current economy poses new challenges.

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