SPG synthesis report - State Coverage Initiatives

The decision by the majority of state grantees to conduct household surveys reflected
their need to improve and expand upon the data provided by CPS, as well as seek
state-specific health insurance coverage data that would better guide policy making.
The SPG-funded state surveys also enabled states to examine county and regional
trends related to the uninsured. The subpopulation analyses undertaken by states are
described in greater detail later in this section.
Many states chose to complement their household surveys with focus groups of state
residents. The focus groups afforded states the opportunity to supplement quantitative
data with qualitative information on the views of uninsured toward health insurance
coverage, their health care-seeking patterns, and barriers they experience in accessing
care.
• Employer surveys and focus groups. States conducted employer surveys and focus
groups to learn more about how employers make decisions about offering coverage
and what their opinions were of different state programs and policy options for
expanding coverage. The employer surveys and focus groups combined to enable
states to examine their own employer behavior and preferences in developing
coverage options. These findings will also serve as a valuable baseline for future
assessment of employer-based coverage.
• Health care environments. States also collected information on their health care
environments to determine the number of employers offering health coverage, the
characteristics of their health care market offerings, and the safety net mechanisms
available to those without coverage.
Every grantee state engaged in an extensive period of information gathering. These
activities yielded nearly 300 reports as states prepared written analyses on their uninsured
populations and potential solutions. These reports deepened states’ understanding of the
uninsured and their health care needs; they also served to assist an important consensus
building process. These reports also provided to the federal government the first in-depth
view of the effects of uninsurance on health care access at the state and local level. To
give a sense of the breadth of topics, here are some examples of excellent reports
produced as a result of the SPG process (a list of state reports can be found in Appendix
D):
Spitz, B. "The Insurers' Perspective on the Health Care System, Insurance, and the
Uninsured," Spitz Consulting Group, June 2002.
The Lewin Group, Cost and Coverage Analysis of Nine Proposals to Expand
Health Insurance Coverage in California, April 2002.
Ratledge, E.C. and T. Toth. "Delaware's Small Employers: The Health Insurance
Dilemma," University of Delaware, April 2001.
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