COBRA ARRA subsidies

Was the carrot enticing enough?

Ilana Yonas, Mary Reed, Vicki Fung, William H. Dow, Joseph P. Newhouse, John Hsu

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objective To help preserve continuity of health insurance coverage during the recent recession, the American Recovery and Reinvestment Act provided a 65 percent Consolidated Omnibus Budget Reconciliation Act (COBRA) premium subsidy for workers laid off in 2008-2010. We examined COBRA enrollment levels with the subsidy and the health, access, and financial consequences of enrollment decisions. Study Design/Data Collection Telephone interviews linked with health system databases for 561 respondents who were laid off in 2009 and eligible for the COBRA subsidy (80 percent response rate). Principal Findings Overall, 38 percent reported enrolling in COBRA and 54 percent reported having some gaps in insurance coverage since being laid off. After adjustments, we found that those who had higher cost-sharing, who had higher incomes, were older, or were sicker were more likely to enroll in COBRA. COBRA enrollees less frequently reported access problems or that their health suffered because of poor access, but they reported greater financial stress due to health care spending. Conclusion Despite the substantial subsidy, a majority of eligible individuals did not enroll in COBRA, and many reported insurance coverage gaps. Nonenrollees reported more access problems and that their health worsened. Without a mandate, subsidies may need to be widely publicized and larger to encourage health insurance enrollment among individuals who suffer a negative income shock.

Original languageEnglish (US)
Pages (from-to)1980-1998
Number of pages19
JournalHealth Services Research
Volume47
Issue number5
DOIs
StatePublished - Oct 1 2012

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Daucus carota
Budgets
Insurance Coverage
Health
Health Insurance
American Recovery and Reinvestment Act
Cost Sharing
Shock
Databases
Interviews
Delivery of Health Care

All Science Journal Classification (ASJC) codes

  • Health Policy

Cite this

Yonas, I., Reed, M., Fung, V., Dow, W. H., Newhouse, J. P., & Hsu, J. (2012). COBRA ARRA subsidies: Was the carrot enticing enough? Health Services Research, 47(5), 1980-1998. https://doi.org/10.1111/j.1475-6773.2012.01409.x

COBRA ARRA subsidies : Was the carrot enticing enough? / Yonas, Ilana; Reed, Mary; Fung, Vicki; Dow, William H.; Newhouse, Joseph P.; Hsu, John.

In: Health Services Research, Vol. 47, No. 5, 01.10.2012, p. 1980-1998.

Research output: Contribution to journalArticle

Yonas, I, Reed, M, Fung, V, Dow, WH, Newhouse, JP & Hsu, J 2012, 'COBRA ARRA subsidies: Was the carrot enticing enough?', Health Services Research, vol. 47, no. 5, pp. 1980-1998. https://doi.org/10.1111/j.1475-6773.2012.01409.x
Yonas, Ilana ; Reed, Mary ; Fung, Vicki ; Dow, William H. ; Newhouse, Joseph P. ; Hsu, John. / COBRA ARRA subsidies : Was the carrot enticing enough?. In: Health Services Research. 2012 ; Vol. 47, No. 5. pp. 1980-1998.
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