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Community Approaches to Caring for Uninsured People

Health Affairs Article Spotlights Activities in 12 Communities

Media Advisory
April 11, 2006

Alwyn Cassil (202) 264-3484 or

WASHINGTON, DC—Faced with rising uninsurance rates and little response from state and federal governments, local communities have developed a range of approaches to provide care to uninsured people, according to a study by the Center for Studying Health System Change (HSC) published today as a Web-exclusive in the journal Health Affairs.

In "Community Approaches to Providing Care for the Uninsured," based on research conducted as part of HSC’s Community Tracking Study (CTS), researchers identified four main approaches to providing care to the uninsured: donated-care programs; discounted care programs; managed care safety net programs; and limited-benefit coverage programs. Community-based programs "are often invaluable to those who are able to enroll," but they tend to "serve only a small proportion of their community’s uninsured residents, barely making a dent in the overall problem," according to the study by Erin Fries Taylor, a researcher at Mathematica Policy Research and an HSC consulting researcher, HSC Senior Researcher Peter Cunningham and HSC Research Assistant Kelly McKenzie.

The difficulties that local leaders face are the same as those that hinder progress at the federal level: money and politics. "Community programs in the CTS sites increasingly are clustered around private-sector strategies, likely because public resources targeted specifically to programs for the uninsured have become more constrained in recent years," Taylor, Cunningham, and McKenzie note. "Greater reliance on the private sector seems to be limiting the scope of these programs in terms of the number of uninsured people served, compared with the managed care programs of the 1990s that could tap into substantial public funds and pursue ambitious enrollment goals."

The article is part of a package of five papers published today on the Health Affairs Web site examining community coverage initiatives. The articles can be read at:

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The Center for Studying Health System Change is a nonpartisan policy research organization committed to providing objective and timely research on the nation’s changing health system to help inform policy makers and contribute to better health care policy. HSC, based in Washington, D.C., is funded principally by The Robert Wood Johnson Foundation and is affiliated with Mathematica Policy Research, Inc.



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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.