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Adam Thompson on July 15, 2008 - 11:12am
Absent a comprehensive initiative to achieve quality and affordable health care for all, there are a number of steps progressive leaders can take to extend coverage to the uninsured and make coverage for the currently insured more affordable.
Extending coverage to all Americans is an economic as well as a moral issue, as the costs associated with being uninsured are not borne by the uninsured alone. In 2005, Families USA showed that unpaid care for the uninsured resulted in an average cost-shift of $922 to family insurance premiums. Families USA, at the time, projected these costs to increase to $1,502 by 2010.
States have drawn from a number of strategies to expand access to coverage and stem the rising percentage of uninsured Americans. While Congress has largely failed to act in recent decades - a primary exception being passage of the State Children's Health Insurance Program (SCHIP) in 1997 - states invested in Medicaid and more than doubled the number of residents receiving Medicaid since the early 1990's, from just over 20 million to at least 55 million. This number doesn't include the 4.5 million children covered by SCHIP which, like Medicaid, is a state/federal partnership with eligibility levels largely set by the states.
In addition to Medicaid and SCHIP, states have developed creative programs that help low-income and middle-income families afford quality coverage while requiring employers to provide coverage or help finance expansions. Maine, Vermont, and Massachusetts have been leaders since 2003, making good coverage more affordable largely through income-based sliding scale subsidies and negotiating better deals from insurance companies.
This section discusses many of the leading options states have to extend coverage to working families.
- Covering All Kids
- Using Medicaid and SCHIP to Cover Adults
- Improve Access to Private Coverage
- Strengthen Employer Responsibility for Health Care
- Provide Health Care for Immigrant Communities
- Funding Health Care Expansions