NCLEJ Report on Barriers Childless Adults Face in Accessing Public Health Insurance

Childless Adults: Barriers to Enrollment in Public Health Insurance (pdf) is a qualitative study of uninsured New Yorkers who are eligible for public coverage but are not enrolled. Beyond its groundbreaking work exploring the specific barriers faced by New York’s 500,000 eligible but uninsured childless adults, the report describes their unique challenges and recommends strategies to improve their participation in public health insurance. Its findings are relevant to the recently enacted federal health care reform law, which expands eligibility for public coverage and will provide New York with significantly enhanced federal financial support for the enrollment of eligible childless adults into Medicaid.

Childless adults often assume they are not eligible for public health insurance. Given the widespread emphasis on enrolling children and families, many childless adults, especially men, assume that public programs are only for families; others assume that having a job of any kind will disqualify them. Further, many have fluctuating income because they work intermittently or seasonally, making proof of their eligibility difficult. This study, which involved interviews with professionals working closely with this population and focus groups with the childless adults themselves, suggests ways to lessen obstacles faced by this population in obtaining health insurance, including options to raise awareness about the importance and availability of health insurance and considerations for simplifying the eligibility determination process.

Prepared by Aviva Goldstein for the National Center for Law and Economic Justice with grant support from the United Hospital Fund, Childless Adults complements another recent United Hospital Fund-supported report by The New York Immigration Coalition, Mutual Responsibility: A Study of Uninsured Immigrants’ Perspectives on Health Insurance in New York City (pdf), which examines barriers to enrollment among immigrants in New York.