As part of a national campaign to raise awareness about the uninsured, program officer Jennifer Edwards joined city leaders in May to speak about the declining quality of employer-sponsored health insurance and the resulting impact on New York's families. Edwards cited a Fund survey of New York employers, conducted by the Health Research and Educational Trust, findings of which showed that in order to manage rising health costs, employers are increasing the share of health plan costs borne by workers and their families. Employee contributions for family health benefits rose by more than 50 percent from 2001 to 2003, from $1,392 to $2,148, and fewer workers opted for family coverage.

Moreover, two of five employers reported they are likely to increase the amount their workers pay in the next year, raising concerns that even more low-wage workers will be unable to afford coverage. Many employers expressed interest in helping lower-wage workers get coverage through public programs for which they may be eligible.⁽²⁴⁾

With private coverage becoming less affordable, the ability of low-income families to obtain and keep their coverage in the state's various health insurance programs is more important than ever. A Fund-supported study conducted by Karen Lipson and colleagues from Manatt, Phelps and Phillips, LLP, found that many children are dropped from the rolls of Child Health Plus B—a program that provides health benefits to low-income children whose family income exceeds Medicaid limits—even though they are eligible to continue receiving coverage. According to the study, 93 percent of children who lost coverage were still eligible at the time of recertification, based on family size and income. The researchers recommend eliminating administrative barriers to retaining coverage as well as lengthening the period of eligibility for low-income children.⁽²⁵⁾ The Fund is supporting new work to explore the administrative and human costs of "churning," or repeated disenrollment and re-enrollment, in coverage programs.

Other Fund-supported work has investigated barriers to enrollment in public programs. Lake Snell Perry, an opinion research firm that focuses on social policy issues, has explored the reasons why many city residents failed to make the transition to Medicaid after their enrollment ended in a temporary program created in the wake of the September 11 terrorist attacks. Out of the 342,000 New Yorkers who signed up for Disaster Relief Medicaid, only 38 percent later applied for standard Medicaid benefits. Focus groups suggested that many people were confused by poor communication and deterred by negative perceptions of the Medicaid application experience.⁽²⁶⁾ Similarly, a study of workers in Chinatown, a neighborhood that was economically devastated by the attacks, found that a lack of accurate or easily accessible information hindered participation in a free, one-year coverage program.⁽²⁷⁾