Beyond health and wealth: Demographic factors associated with purchase of non-group health insurance

The non-group health insurance market currently serves as a long-term source of coverage for some individuals without access to employer or publicly-sponsored insurance, and as a transitional source of coverage between periods of employer coverage. In recent years policymakers have proposed increasing the number of people insured through this market to meet two different goals. Some advocate that the non-group insurance market can be used to decrease the number of individuals who are uninsured. Others focus on the market as a means to decrease health care costs to both individuals and society. The theory that the market can decrease health care costs is based on the assumption that if individuals chose from many health insurance plans they will be price sensitive and pick less expensive plans, and plans will have an incentive to keep costs down to attract customers.;The need to address the problems of access for people with health problems, and for those who cannot afford premium prices in the non-group market, have been recognized in the debate over implementing public policies that encourage purchase of insurance in this market. Less attention has been paid to other factors such as individuals' ability to navigate the complexities of the non-group market.;Using data from the 2005 Medical Expenditure Panel Survey, this paper uses logistic regression to examine whether possessing knowledge about health insurance and having the ability to navigate the non-group market impact purchase decisions. These factors are not directly measurable, and this study will focus on education level, ethnic and racial minority group status, and English language ability as factors that may be correlated with knowledge about insurance. The results indicate that those who are black or Hispanic, those with limited ability to speak English, and those with lower education levels are less likely to purchase non-group health insurance, controlling for other demographic characteristics and health status. The results of this study indicate that policies aiming to use the non-group market to expand insurance coverage could exacerbate existing disparities in health insurance coverage. If policies do attempt to use the non-group market to extend health insurance coverage to the uninsured special outreach to the populations examined in this study could help mitigate any negative effects.