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Am J Public Health. 2003 Jan;93(1):67-74.

What other programs can teach us: increasing participation in health insurance programs.

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  • 1Department of Health Policy and Management, Mailman School of Public Health, Columbia University, New York, NY 10032, USA.


Many uninsured Americans are already eligible for free or low-cost public coverage through Medicaid or Children's Health Insurance Program (CHIP) but do not "take up" that coverage. However, several other public programs, such as food stamps and unemployment insurance, also have less-than-complete take-up rates, and take-up rates vary considerably among programs. This article examines the take-up literature across a variety of programs to learn what effects nonfinancial features, such as administrative complexity, have on take-up. We find that making benefit receipt automatic is the most effective means of ensuring high take-up, while there is little evidence that stigma is important.

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