Federal plan would cut uninsured only in some areas, report finds
TUESDAY, June 7 (HealthDay News) -- The impact of U.S. federal government health insurance proposals, such as tax credits or expanded public coverage, would vary widely state-to-state, according to a study released Tuesday.
The proposals could reduce by 20 percent the number of uninsured people in some states, the Columbia University team conclude. On the other hand, they would have no impact on states that already provide expanded coverage to low-income people or states where, even with a tax credit, premiums remain too costly for uninsured, low-income people to afford coverage.
"The message is that there is no simple solution that will work for all the uninsured, so we need a variety of solutions. In some states, the problem of the uninsured is related to the high cost of health insurance, and in other states it is more closely linked to high rates of poverty among the uninsured," study co-author Sherry Glied, a professor in the department of health policy and management at Columbia's Mailman School of Public Health, said in a prepared statement. The study received support from the nonprofit Commonwealth Fund.
The report, Variations in the Impact of Health Coverage Expansion Proposals Across States, was published online as a Health Affairs exclusive.
The researchers looked at five different federal government policy proposals, and concluded that the numbers of new insured people in each state would vary under the proposals. The researchers' assessment was based on the income of the uninsured, existing state coverage policies and rates of insured people, and the insurance market in each state.
The study concluded that rates of uninsured people would drop by more than 15 percent in Kansas, Oregon and Utah under a scheme involving tax credit for low-income people. A proposed expansion of Medicaid coverage to adults with incomes below 133 percent of the federal poverty level would have the greatest effect in states such as Arkansas, Kentucky, Louisiana and Mississippi. In these states, this expansion of Medicaid coverage would reduce the number of uninsured people by up to 18 percent.
The federal proposal is not a one-size-fits-all plan benefiting all states equally, the researchers conclude. "Federal policies to increase health insurance coverage would be more effective if they took into account the variety of economic structures, insurance markets, and the situations of uninsured individuals across states," Glied said.
SOURCE: Commonwealth Fund, news release, June 7, 2005
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