Senators Clinton and Obama are continuing
the debate over how best to ensure that everyone has health insurance
and access to care.
Some online analysts have raised questions about the effectiveness of mandates by reviewing car insurance mandates.
We have been spending some time looking at access to car insurance in our transportation research.
Car insurance is regulated by states. Only two states do not require
drivers to maintain insurance – New Hampshire and Wisconsin. Yet, a recent report finds that nearly 15 percent of drivers across the nation are uninsured.
What happens in the two states without a mandate?
Wisconsin ranks 20th with about 14 percent uninsured, while New
Hampshire has one of the lowest rates of all states at 9 percent. Other
state rates range from 26 percent (Mississippi) to 4 percent (Maine).
Some writers have noted that California has a low-cost insurance
option for low-wage workers. In that state, these writers point out,
the uninsured rate is one of the highest at 25%.
We’ve interviewed some of the key actors implementing the California
low-cost insurance option and find that there is a major problem with
outreach and access. Most low-wage workers probably don’t even know
about the option and the incentives don’t seem to be structured in a
way that encourages brokers to sell it.
A number of people are working on improving knowledge and use of the
low-cost option in California, but we should not assume that low-wage
drivers wouldn’t buy it—-if they knew about it.
So, what do we know? A mandate does not guarantee universal coverage
in this case. And creating and implementing a lower-cost insurance
option for low-wage workers will require creativity, careful
implementation, and outreach.