The State Health Insurance Assistance Program — A National Study of a Decentralized Program

This project will: 1) evaluate whether State Health Insurance Assistance Programs (SHIPs) serve beneficiaries across all income levels; 2) identify barriers that may prevent low-income beneficiaries from utilizing SHIPs; and 3) evaluate if SHIPs consistently have the expertise necessary to counsel beneficiaries on coverage decisions. The project will characterize the socioeconomic conditions in the counties in which each SHIP counseling site is located to determine whether SHIP counseling sites are disproportionately located in higher-income communities. The second component of the project includes interviews with a geographically diverse set of SHIP program staff to identify barriers to SHIP service provision to low-income beneficiaries. The third component will use mystery shopping of SHIPs in low- and high-income areas in five states to determine if SHIPs offer services in multiple languages and offer correct information. Data sources include state directories of SHIP counseling sites, county-level population characteristics, the Agency for Healthcare Research and Quality Social Determinants of Health file, and the Centers for Medicare and Medicaid Services Prescription Drug Plan file.