How to explain the non-use of the Aide à l'acquisition d'une complémentaire santé? The results of a survey of potential beneficiaries in Lille in 2009.

Summary The Aide à l'acquisition d'une complémentaire santé (ACS) is a scheme, in the form of financial assistance, set up in 2005 to promote access to health care for people with incomes just above the ceiling for eligibility for the Couverture maladie universelle complémentaire (CMU-C). Despite its increase in coverage, non-use of the ACS is significant, with only 22% of eligible individuals having claimed their right in 2011 (Fonds CMU, 2012). In this context, understanding the reasons for non-take-up seems essential to improve the effectiveness of the system and enable people on low incomes to access complementary health insurance. Following a social experiment, a survey was carried out in 2009 in Lille among people potentially eligible for the ACS in order to better understand their characteristics and their motivations or obstacles to using the system. The results of this survey show that the population identified as eligible for the ACS in Lille is faced with economic and social difficulties and has significant healthcare needs. However, the ACS take-up rate is low, with only 18% of people having taken steps to obtain it. The reasons most often given for not taking up the ACS are: the belief that they are not eligible, lack of information, the complexity of the procedures and, for those not covered, the price of the complementary health insurance, even after deducting the health check.