"Scale of Justice," as seen on the staircase in DePaul University's College of Law. (DePaul University/Jamie Moncrief)Wendy Netter Epstein, professor and associate dean of the DePaul University College of Law, and two colleagues at other universities have been awarded a grant to study whether "generosity framing" can encourage the purchase of health insurance.
The research by Epstein, Christopher Robertson, professor at Boston University School of Law, and David Yokum, director of the Policy Lab at Brown University, aims to learn whether uninsured consumers become more likely to buy a policy when told that doing so will subsidize insurance for the sick. Such generosity framing builds on people's latent desire for altruism or social responsibility.
The Robert Wood Johnson Foundation Evidence for Action program awarded the educators a $388,244 grant for their research, which will run from July 2021 through June 2023 and be administered by DePaul.
Wendy Netter Epstein (DePaul University)
"The U.S. has an uninsured problem," Epstein says. "Even before the pandemic, nearly 30 million Americans were uninsured, and COVID-related job losses and the economic downturn exacerbated it at the worst time. With fewer people having access to employer-sponsored coverage, more Americans should be turning to the exchanges to purchase policies. The new Biden Administration subsidies are helping, but without universal coverage, too many are still uninsured."
Using a three-phase approach, the researchers will first conduct focus groups in two partner states, Rhode Island and Massachusetts, to understand consumer perspectives and to optimize the presentation of these ideas. In the second phase, the researchers will conduct a randomized field experiment using internet advertisements, studying actual consumer behaviors. The final phase will partner directly with Health Benefit Exchange in Maryland and Healthsource RI in Rhode Island, incorporating insights from the prior phases to manipulate direct mail and email marketing materials for uninsured residents and to observe differences in health insurance purchasing behavior.
"Generosity framing has not been directly tested for health insurance purposes. But positive effects have been found in other domains, and generosity and social responsibility are concepts increasingly used to market all sorts of products," Epstein says. "In health specifically, Americans already overwhelmingly support laws that require insurers to sell policies to those with pre-existing conditions without charging them more. This only works if healthy people also purchase policies."
A primary goal of this research is to better understand how people will respond to generosity framing, with a key emphasis on addressing racial and ethnic disparities in health insurance uptake. The researchers are committed to studying a diverse population and to conducting phases of the project in both English and Spanish.
"If generosity framing is effective," Epstein says, "our findings have the potential to be readily adopted in our partner states and more broadly. Results will also inform efforts to ultimately achieve a universal coverage system."
Disclaimer: Support for this work was provided by the Robert Wood Johnson Foundation. The views expressed here do not necessarily reflect the views of the Foundation.