The demand for health insurance among uninsured Americans: results of a survey experiment and implications for policy

J Health Econ. 2013 Sep;32(5):780-93. doi: 10.1016/j.jhealeco.2012.09.005. Epub 2013 Feb 26.


Most existing work on the demand for health insurance focuses on employees' decisions to enroll in employer-provided plans. Yet any attempt to achieve universal coverage must focus on the uninsured, the vast majority of whom are not offered employer-sponsored insurance. In the summer of 2008, we conducted a survey experiment to assess the willingness to pay for a health plan among a large sample of uninsured Americans. The experiment yields price elasticities of around one, substantially greater than those found in most previous studies. We use these results to estimate coverage expansion under the Affordable Care Act, with and without an individual mandate. We estimate that 35 million uninsured individuals would gain coverage and find limited evidence of adverse selection.

Keywords: Affordable Care Act; H25; H51; Health insurance; I13; I14; Uninsured.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Female
  • Humans
  • Insurance Coverage*
  • Insurance, Health*
  • Intention
  • Male
  • Medicaid / statistics & numerical data
  • Medically Uninsured* / statistics & numerical data
  • Middle Aged
  • Needs Assessment / statistics & numerical data
  • Patient Protection and Affordable Care Act
  • Policy Making*
  • Surveys and Questionnaires
  • United States
  • Young Adult