Linda J. Blumberg, Ph.D.

Over the course of two HCFO grants, Linda Blumberg, Ph.D., at the Urban Institute has examined a very pressing health care policy issue: uninsured Americans. Dr. Blumberg has made unique contributions in describing the characteristics of the uninsured as well as patterns of coverage among individuals and families. In addition, she has studied differences among several major national surveys that are commonly used to study the uninsured.

In her first HCFO study, focused largely on low-income workers and the barriers they face to health insurance enrollment, Dr. Blumberg and colleagues Amy Davidoff, Len Nichols, and Bowen Garrett found that subpopulations of the working uninsured require different approaches to increase enrollment. Specifically, policymakers should consider how to better target low-income workers, adult employees without children, Hispanic and non-citizen employees, and workers in large firms.

According to Dr. Blumberg, “While it was relatively common knowledge that the low-income workers were substantially less likely to have coverage than others, this research helped clarify what makes the low-income uninsured different from the low-income insured. It also offered an opportunity to highlight a significant, but often overlooked segment of the working uninsured population: those employed in large firms.”

Dr. Blumberg’s current HCFO project with co-principal investigator Lisa Dubay is examining the dynamics of health insurance coverage during the rapidly changing period of 1996 to 2000. Welfare reform in the latter half of the 1990s produced many changes in both public and private insurance coverage. While implementation of the State Children’s Health Insurance Program (SCHIP) expanded coverage to many children and an economic boom increased employer-sponsored insurance coverage, welfare reforms decreased cash assistance and led to discontinuities in Medicaid coverage to some families. This new research will identify coverage patterns among children, adults, and families during this period, and measure unintended consequences such as crowd-out and spillover effects of SCHIP outreach efforts. Dr. Blumberg notes that this information is vital for federal and state policymakers as they attempt to design public assistance programs in ways that are mindful of the potential interactive effects of new programs and the decisions of individuals, families, and employers.

Dr. Blumberg also conducts research on the importance of health insurance risk pools, tax credits as a mechanism for expanding coverage, reinsurance, worker job sorting for health insurance benefits, and the potential effects of proposals to expand coverage. The focus of her research is to understand the dynamics of private health insurance markets, their interactions with public insurance programs, and mechanisms for structuring and financing coverage expansions. For example, she and colleagues Yu-Chu Shen, Len Nichols, Matthew Buettgens, Lisa Dubay, and Stacey McMorrow developed the Health Insurance Reform Simulation Model (HIRSM); HIRSM is designed to simulate the coverage, cost, risk pool, and tax implications of proposals to expand health insurance coverage or to reform insurance markets. It is predicated on the notion that reform effects will be a function of the complex interactions of the behavior of employers, workers, insurers, and those outside of the labor market. Blumberg and colleagues’ recent report, “The Health Insurance Reform Simulation Model (HIRSM): Methodological Detail and Prototypical Simulation Results” details the model’s construction as well as the prototypical simulated effects of a health insurance tax credit, a public program expansion, and a hybrid of the two approaches. Policymakers can use this research to project potential outcomes of these various policy alternatives.

Dr. Blumberg is senior research associate at The Urban Institute in Washington, D.C. Dr. Blumberg has also done research with funding from The Robert Wood Johnson Foundation’s Economic Research Initiative on the Uninsured and State Coverage Initiatives programs, the Kaiser Family Foundation, the Commonwealth Fund, the California Healthcare Foundation, and the U.S. Departments of Labor and Health and Human Services. Formerly, she served as a health policy advisor in the Office of Management and Budget during the Clinton administration’s initial health care reform effort.

Dr. Blumberg received her Ph.D. in economics from the University of Michigan and her bachelor’s degree from the University of Illinois.

Articles from HCFO-funded projects

Blumberg, Linda J. and Amy J. Davidoff. 2002. “Consider the Source: Studying Low-Income Uninsured Workers Using Three Different Surveys.” Washington: The Urban Institute. Urban Institute working paper.

Blumberg, Linda J. and Amy J. Davidoff. 2003. “Exploring State Variation in Uninsurance Rates Among Low-Income Workers.” Washington: The Urban Institute. New Federalism Policy Brief, Series B, No. B-56.

Blumberg, Linda J. and Amy J. Davidoff. 2002. “Understanding the Relationships Between the Health Status of Workers, their Families, and the Purchase of Non-Group Health Insurance.” Washington: The Urban Institute. Urban Institute working paper.

Blumberg, Linda J. et al. 2002. “Who are the Working Uninsured? An Analysis Using the National Health Interview Survey.” Washington: The Urban Institute. Urban Institute working paper.

Blumberg, Linda J. and A. Bowen Garrett. 2002. “Big Firms, No Benefits: The Forgotten Uninsured.” Washington: The Urban Institute. Urban Institute working paper.

Davidoff, Amy J., Linda J. Blumberg, and Len M. Nichols. 2002. “State Health Insurance Market Reforms and Access to Insurance for High Risk Employees.” Washington: The Urban Institute. Urban Institute working paper.