The Cost of Doing Nothing Why the Cost of Failing to Fix Our Health System Is Greater than the Cost of Reform

Elizabeth Carpenter, Sarah Axeen, New America Foundation
November 13, 2008.

The economic cost of failing to fix our broken health care system is greater than the upfront expense of comprehensive health reform. In 2006, our economy lost as much as $200 billion because of the poor health and shorter lifespan of the uninsured. This is by most estimates as much as, if not greater than, the public costs of ensuring all Americans have quality, affordable, health coverage. For the full text of this report and the accompanying state profiles, see Full report (125 pp.)

Immigration and Health Care: What are the Policy Choices? (Webcast)

The Kaiser Family Foundation hosts a live webcast, “Immigration and Health Care: What are the Policy Choices?,” at 3 p.m. ET on Wednesday, March 12 as part of an ongoing series of interactive webcasts about health and health care disparities in the U.S. A panel of experts will discuss the influence that immigration policies have on federal and state decisions about access to health care and coverage. Marsha Lillie-Blanton, Dr.P.H., senior adviser on Race/Ethnicity & Health Care at the Kaiser Family Foundation will moderate the discussion with Tom Perez, M.P.P., J.D., secretary of the Maryland Department of Labor, Licensing and Regulation and former director of the Office for Civil Rights at the Department of Health and Human Services; Leighton Ku, M.P.H., Ph.D., professor of health policy at the George Washington University School of Public Health & Health Services; and Steven Camarota, Ph.D., director of research at the Center for Immigration Studies. Submit questions before or during the show to TodaysTopics@kaisernetwork.org. The live webcast will be available online at kaisernetwork.org. <!– // djd 110503: old location: new location at top right
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Getting to Universal Health Insurance Coverage Conference

National Academy of Social Insurance’s 20th annual policy conference focused on achieving affordable health coverage for all Americans. The conference brought together the major participants in the health coverage debate to frame the problem, compares specific policy proposals, and identified ways of overcoming the obstacles to reform. Video and transcripts for Day 1 and Day 2 re available through kaisernet.org.

A Consumer Guide to State Health Reform (on-line guide)

Community Catalyst and Families USA are working with health care advocates in states across the nation to expand access to affordable quality health care to as many citizens as possible.  Based upon our collaborative work with advocates in Colorado, we have summarized different state experiences and used it to develop this new online tool to help advocates consider all of the options available.This guide will help advocates design health coverage expansions that build upon the current system of public programs, employer-sponsored insurance and private market options.  Start by laying a strong foundation through Medicaid and State Children’s Health Insurance (SCHIP) coverage; then by regulating the private insurance market; next by building subsidy programs and pooling mechanisms; by ensuring adequate benefits and access to services; and finally by finding sustainable financing.  Web site.

A Progress Report On State Health Access Reform

John E. McDonough, Michael Miller, and Christine Barber. A Progress Report On State Health Access Reform. Health Affairs Web Exclusive, January 29, 2008.

Enactment of ambitious health reform laws in Massachusetts and Vermont in 2006 helped instigate a wave of state legislative activities to expand coverage to uninsured people. We identify thirty-nine states that have enacted laws in at least one access category since 2006. At least thirteen states have begun processes to enact comprehensive reforms to cover at least half of their uninsured residents. Key activities involve coverage expansions for uninsured children and for uninsured adults; regulatory changes in small-group and individual insurance markets; and individual and employer mandates. The future extent and durability of this wave are uncertain.  Abstract (html)

State Efforts to Reduce Number of Uninsured being Compromised

New reports released today by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) describe aggressive efforts by states in the past year and a half to expand coverage to low-income children and their families, but the actions may be curtailed as a deteriorating economic climate and new limits on federal assistance take effect.  A downturn in the economy, the federal failure to reauthorize the State Children’s Health Insurance Program (SCHIP) and new federal rules affecting Medicaid and SCHIP eligibility all suggest that the recent period of aggressive expansion of coverage by states may be over. This is the conclusion based on a series of new studies by the KCMU, including a 50-state survey of eligibility and enrollment rules in Medicaid and SCHIP for children and families, interviews with Medicaid directors in ten states representing all regions of the country, and recent studies of enrollment in Medicaid and SCHIP.The reports released today include: * Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles,
* Current Issues in Medicaid: A Mid – FY 2008 Update Based on a Discussion with Medicaid Directors,
* SCHIP Enrollment in June 2007: An Update on Current Enrollment and SCHIP Policy Directions,
* Medicaid Enrollment in 50 States: December 2006 Data Update, and
* State Children’s Health Insurance Program (SCHIP): Reauthorization History.

They can all be found online here, along with some key publications that explain the impact of federal fiscal relief for Medicaid in the last recession.

Cyber-seminar: Leading the Way? Maine’s Experience in Expanding Coverage

In 2003, Maine passed the Dirigo Health Reform Act with a goal of affordable health care coverage for all Maine citizens by 2009. While Maine was a leader in passing comprehensive reform legislation, other states have followed, and have passed similar measures or are contemplating their own proposals to provide universal coverage.

In new research jointly funded by the Robert Wood Johnson Foundation’s Changes in Health Care Financing and Organization (HCFO) Initiative and The Commonwealth Fund’s State Innovations Program, Debra Lipson and Jim Verdier from Mathematica Policy Research, Inc., have evaluated the development and progress of Maine’s efforts to date.  During this Cyber Seminar, the researchers will discuss their evaluation of Maine’s efforts to expand coverage, slow the growth in health care costs and improve quality of care. Trish Riley and Karynlee Harrington from the State of Maine and Enrique Martinez-Vidal from RWJF’s State Coverage Initiatives program will discuss the findings, including potential lessons for other states. Registration will close on Monday January 28, 2008 at 12:00 p.m. (EST).

Cyber Seminar on February 1, 2008 12:00 p.m. – 1:30 p.m. (EST)

Universal health care plans up against U.S. law

Julie Appleby writes in USA Today (1/16/08) “Several states and communities are moving to provide universal health coverage for their residents, but a federal law is blocking their efforts….An early legal test of these plans is taking place in San Francisco, the first city to offer universal coverage to its residents. A group of restaurant owners sued the city in 2006, saying the law violates the federal Employee Retirement Income and Security Act (ERISA).

In December, a lower court judge sided with employers. But last week, an appeals court allowed San Francisco to proceed temporarily with its program and begin charging employers a fee, ruling that the city has a “strong likelihood of prevailing” in its appeal.

California, Colorado, Michigan and Minnesota have proposals pending that rely on partial funding by employers. The lower court ruling “raises doubt with regard to all of the state health reform proposals,” says Atlanta attorney John Hickman, an expert on the federal law.” Full article (html)

2008 State Legislators’ Guide to Health Insurance Solutions and Glossary

The American Legislative Exchange Council and Council for Affordable Health Insurance have released a guide for state policymakers meant to identify the issues and examine the pros and cons of various solutions. The Guide explains who the uninsured are and what can be done to address that problem. It summarizes various issues facing state legislators, highlighted actions already taken by states, and offered solutions; there also is a glossary that explains a number of industry terms. Full report (pdf)