Lisa Clemans-Cope, Ph.D. and Cynthia D. Perry, Ph.D.

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September 1, 2008

Lisa Clemans-Cope, Ph.D., is a research associate for the Health Policy Center at the Urban Institute. She received a B.A. in economics from Princeton University and a Ph.D. in health economics from the Bloomberg School of Public Health at Johns Hopkins University. Dr. Clemans-Cope's work has focused on issues related to health insurance and health care reform. In research studies, she has examined the impact of various public policies to reduce private health insurance premiums and expand health insurance coverage, as well as the development of microsimulation models to examine state and national reform proposals, changes in the offering and up-take of employer-sponsored health insurance, and the effects of public policy on access to health care, service utilization, and enrollment in health insurance plans for vulnerable populations.

Cynthia Perry, Ph.D., is also a research associate at the Urban Institute's Health Policy Center. She earned a B.A. from Boston College in economics and a Ph.D. in economics from the Massachusetts Institute of Technology. Dr. Perry spent two years as a Robert Wood Johnson Health Policy Scholar at Harvard University. During this time, she studied the effects of maternal depression on child health management. Dr. Perry's research has included investigating the effects of health insurance on child health outcomes, access to and the quality of preventive care for children, and health insurance coverage for low-income working families.

Drs. Clemans-Cope and Perry are co-principal investigators on a HCFO-sponsored study funded through a special topic solicitation on health care costs. The researchers will examine how using different measures of affordability as a tool for subsidizing health insurance affect access to health insurance for those who are currently uninsured and those who have chronic health conditions with high health expenditures. Dr. Perry explains, "Using affordability standards to define and target premium subsidies or tax credits can help guard against a high financial burden, even among those with coverage, since insurance coverage itself does not always provide protection from increasing health expenditures. This is particularly true for those with low incomes and those with chronic health conditions."

The researchers will use several national data sets to estimate total and out-of-pocket expenditures for individuals under standard benefit packages purchased in the group or non-group market. Total and out-of-pocket expenditures will then be predicted for uninsured individuals as if they were insured through their best available option in the group or non-group market. In their study, the researchers define total health care spending as premiums and out-of-pocket costs, and they define these costs as "affordable" if they fall below a given standard of spending as a percent of family income. With these data and this measure of affordability, the researchers will: 1) describe the availability of affordable health insurance among the currently insured and uninsured populations; and 2) explain why take-up of health insurance varies, given affordability.

The number of Americans without health insurance continues to rise as many individuals find health insurance coverage to be unaffordable. Drs. Clemans-Cope and Perry note a principal objective of this research is to provide empirical evidence on various measures of affordability, to inform the construction of policies intended to increase coverage and ensure equitable financial burden for those who acquire coverage. Dr. Clemans-Cope adds, "Many policymakers are aware that the lack of affordable health insurance plays an important role in the growing number of uninsured. However, it is difficult to define what is 'affordable' for different Americans. We believe our findings will be of interest to policymakers and others at the state and federal level as health insurance reforms such as premium subsidies and mandates to purchase coverage are considered."

For more information on these grantees and a list of publications, see:

Lisa Clemans-Cope, Ph.D.:

Cynthia Perry, Ph.D.: