Increasing Health Insurance Costs and the Decline in Insurance Coverage (original) (raw)

Covering the Uninsured: Estimates of the Impact on Total Health Expenditures for 2002

2004

This study estimates the change in national health expenditures that would result if all uninsured persons in the non-elderly population were given health insurance coverage. Our analysis assumes that, after adjusting for individual characteristics, the uninsured, when given coverage, would spend the same for health care as the previously insured. We find that expanding public coverage would have cost 38.1to38.1 to 38.1to41.3 billion in 2002, while expanding private coverage would have cost 53.8to53.8 to 53.8to67.4 billion. These estimates are adjusted for uncompensated care and administrative costs. Public coverage is less costly than private coverage because of lower provider reimbursement rates. G. Edward Miller Division of Modeling and Simulation Center for Financing Access and Cost Trends Agency for Healthcare Research and Quality U.S. Department of Health and Human Services Agency for Healthcare Research and Quality (AHRQ) 540 Gaither Road Rockville, MD 20850 emiller@ahrq.gov Jessica S. Banthin D...

Health Care Coverage: Uninsurance -- The Unintended Consequence

2001

One of welfare reform's unintended consequences has been a reduction of health care coverage among poor Americans. The welfare law severed the link between cash assistance and Medicaid. In turn, Congress provided states with several options to continue to offer Medicaid to those leaving welfare and to expand health coverage to more low-income families. Nonetheless, many low-income people lost health care coverage as they moved from welfare to work. This paper provides a statistical portrait of changes in health insurance coverage, and the policy measures that states have taken to fix the problem

Treatment or Placebo: Are State Programs Decreasing the Proportion of Uninsured?

Policy Studies Journal, 2008

Currently there are over 45 million Americans without health insurance. Recent growth in Medicaid and State Children's Health Insurance Program (SCHIP) enrollment of children has filled in the sizable gap created by decreased employer-sponsored insurance since 2000. While the share of children who are uninsured actually decreased between 2000 and 2003, little progress was made in expanding public insurance to adults. As a result, advocates and policymakers at the federal and state level are searching for approaches to deal with the growing number of the uninsured. Conservatives advocate encouraging individuals to buy private insurance while liberals advocate the provision of health coverage through publicly financed health care. Using a 50-state multilevel individual growth model, this study estimates the net effect of two state approaches in terms of reducing the uninsured: tax incentives (the conservative approach) and direct-coverage programs (the liberal approach). The results suggest that these approaches have not achieved the results that many advocates had suggested. In the case of tax incentives, the results suggest that states with tax incentives experience increases in the rate of the uninsured. In the case of direct-coverage programs, results suggest that states receive no relief in the number of uninsured individuals. Finally, the analysis suggests that the efforts originating at the federal level are most successful. These programs are a continuation of the incremental approach policymakers in America have taken to address the problem of the uninsured, rather than taking steps toward a truly comprehensive solution.

The uninsured: an analysis by income and geography

Rural policy brief, 2013

Key Findings. (1) A larger proportion of the rural population than the urban population is uninsured and low income (living at or below 138% of the federal poverty line [FPL]) (9.9% as compared to 8.5%) and a larger proportion of the rural population than the urban population will be eligible for subsidized Health Insurance Marketplace (HIM) coverage due to income levels and current lack of insurance (10.7% as compared to 9.6%). (2) Assuming full Medicaid expansion, a larger proportion of the rural uninsured than the urban uninsured would be eligible for Medicaid (43.5% as compared to 38.5%). (3) A smaller proportion of the rural uninsured than the urban uninsured has income above 400% FPL and thus will not qualify for either Medicaid or HIM subsidies (10% as compared to 14.1%). (4) The proportion of the uninsured population potentially eligible for Medicaid expansion is highest in the rural South (47.5%) and lowest in the urban Northeast (32.5%) and the rural Northeast (35.8%).

Health Insurance: Uninsured by State, 2000

2002

An estimated 14.0% of the U.S. population lacked health insurance coverage in 2000, down from 14.3% in 1999. When examined by state, estimates of the percent uninsured ranged from a low of 5.9% in Rhode Island to a high of 23.8% in New Mexico. Generally, states in the Midwest and New England have lower rates of uninsured, while states in the Southwestern portion of the nation have higher shares of their populations without coverage. These state-level estimates are based on the March 2001 Current Population Survey (CPS), and must be interpreted with caution because they are based on survey samples. When sampling variation is taken into account, to allow one to say with 90% reliability that the percent uninsured in the state lies between specified low and high estimates, the uninsured rate in 14 states and the District of Columbia is not different statistically from the uninsured rate nationwide. The uninsured rate is statistically lower than the national rate in 24 states, and statistically higher in the remaining 12 states. State-level analysis is only one way to examine data about health insurance coverage. Some factors related to the percent of a state's population that is uninsured may be affected by the state, such as eligibility criteria for the state's Medicaid and State Children's Health Insurance programs or other programs for those lacking health insurance. Other factors may be beyond the state's direct control, such as the willingness of employers to offer coverage and the financial resources of the state's population to purchase coverage. This report will be updated annually, when new data become available. For related information,

The Effect of Health Insurance Coverage on the Use of Medical Services

American Economic Journal: Economic Policy, 2012

Substantial uncertainty exists regarding the causal effect of health insurance on the utilization of care. Most studies cannot determine whether the large differences in healthcare utilization between the insured and the uninsured are due to insurance status or to other unobserved differences between the two groups. In this paper, we exploit a sharp change in insurance coverage rates that results from young adults "aging out" of their parents' insurance plans to estimate the effect of insurance coverage on the utilization of emergency department (ED) and inpatient services. Using the National Health Interview Survey (NHIS) and a census of emergency department records and hospital discharge records from seven states, we find that aging out results in an abrupt 5 to 8 percentage point reduction in the probability of having health insurance. We find that not having insurance leads to a 40 percent reduction in ED visits and a 61 percent reduction in inpatient hospital admissions. The drop in ED visits and inpatient admissions is due entirely to reductions in the care provided by privately owned hospitals, with particularly large reductions at for profit hospitals. The results imply that expanding health insurance coverage would result in a substantial increase in care provided to currently uninsured individuals.

Health Insurance: Uninsured by State, 2001

2002

Americans' health insurance coverage, 1980-91

Health care financing review, 1992

The authors of this article have used Current Population Surveys to summarize public and private health insurance trends in the United States over the last 12 years. Key findings include the declining percentage of the non-elderly population with employer-sponsored coverage and increasing numbers of low- and middle-income uninsured. That is, in a period of fast-rising health care costs, the poor and the near-poor in working families have been losing coverage for health care and facing increasing risks of inadequate care and financial loss. These data highlight health care access and financing problems now facing the Nation.

Increasing Health Insurance Costs and the Decline in Insurance Coverage (original) (raw)

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