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National Health Insurance and the Homeless

Brent Kreider and Sean Nicholson

Health Economics, Jan-Feb. 1997, 31-41

There is very little known about health care utilization among the homeless or about the role of
health insurance on utilization patterns. Many health care reform proposals advocate expanding
health insurance coverage for various segments of society, including the homeless. Although
homeless people who lack health insurance face strong financial barriers to health services,
providing them with health insurance may not appreciably increase their demand for health care
if they also face important nonfinancial barriers. We investigate the relationship between insurance
and utilization for this group based on estimates from an empirical model of medical care use and
insurance coverage. Using our estimates, we simulate potential effects of policy changes on
various types of utilization, including use of mental health services and treatment for alcohol
or other drug abuse.