What Other Programs Can Teach Us: Increasing Participation in Health Insurance Programs

The pervasively low take-up rates for certain public benefits&#8212that is, the rate at which people who are eligible for a program enroll&#8212have been a major cause of uninsurance in the United States. Millions of Americans are eligible for public programs such as Medicaid, but never sign up for them. Why not take free, or nearly free, care when offered?

This issue recently was tackled by researchers at the Mailman School of Public Health at Columbia University in "What Other Programs Can Teach Us: Increasing Participation in Health Insurance Programs," a study funded by The Commonwealth Fund that appeared in the American Journal of Public Health. After examining factors that influence take-up behavior across a wide range of public programs, authors Dahlia K. Remler, Ph.D., and Sherry A. Glied, Ph.D., concluded that programs with an automatic enrollment feature have the highest takeup rates. Based on this finding, Remler and Glied recommend introducing automatic enrollment in public insurance to improve