A survey of basic resource needs: Results from a sample of Kaiser Permanente Southern California members

Background: Kaiser Permanente (KP) has offered subsidized insurance under the Affordable Care Act since 2014. Individuals and families with household incomes between 100% and 400% of the federal poverty level who legally reside in the US and lack access to affordable employer-sponsored insurance coverage are eligible for these federally-funded subsidies. While many initiatives have focused on Medicaid coverage, little is known about the basic resource needs of KP members who received subsidized insurance.

Approach: To define the basic resource needs of KP members receiving subsidized insurance, the KP Social Needs Network for Evaluation and Translation (SONNET) conducted a survey in 2018-19 with support from KP National Community Health. We randomly selected over 1,000 members with a subsidy from the Southern California region. An equal number of members ages 18-30, 30-64 and 65+ were invited to participate. The majority of participants who received subsidized insurance and were aged 65 and over were transitioning to Medicare; a minority retained a subsidized plan. A subgroup is receiving a follow-up survey 3 or 6 months after their initial survey. The survey consists of up to 48 questions from the KP-developed Your Current Life Situation (YCLS) questionnaire, the Accountable Health Communities (AHC) survey developed by the Centers for Medicare and Medicaid Services, and other sources. The survey was administered by the KP Washington Health Research Institute’s Survey Research Program. Members responded between November 2018 and February 2019 (online, phone, or paper). Each respondent received a $20 cash incentive. We balanced sampling by gender and invited 20% Spanish and 80% English speakers to participate. 487 (48%) completed the survey (84% in English, 16% in Spanish). More women than men completed the survey (56% vs. 44%).

In this report, we focus on four basic resource needs (housing, food, transportation, and utilities), and describe: 1) the prevalence of those needs in the last 3 months; 2) members’ desire for assistance from KP in addressing those needs; 3) and the extent to which KP has helped them address these needs.