John Holahan, Center Director

The fight over reauthorizing the State Children’s Health Insurance Program (SCHIP) made headlines near the end of 2007. The Health Policy Center informed the debate in the media and on Capitol Hill. Opponents of the expansion plan claimed it didn’t target low-income children, but our research showed otherwise: roughly 70 percent of the children who would be covered by the congressionally approved plan were in families with low incomes. When President Bush proposed tax deductions to subsidize health insurance, we determined that low-income families would fare better if SCHIP were expanded.

The most devastating consequences of uninsurance in this country are thousands of Americans who die every year because they lack health insurance. We built upon an earlier Institute of Medicine study on mortality and the uninsured. Preliminary results show that 137,000 people died from 2000 through 2006 because they had no health insurance.

Our 2007 research on Medicaid led to highly practical and widely discussed proposals.  In Health Affairs, we spelled out Medicaid reform options that would expand coverage, give states some financial breaks, shift some responsibility to the federal government, and fix problems with the program. New research sought strategies to improve Medicaid’s outreach and boost the enrollment of pregnant women.

Our evaluation of the Healthy Kids Program in Los Angeles found that health insurance coverage rose among low-income and immigrant children, as intended. We also analyzed why parents do not apply for coverage for their kids and how access to the program could be improved.

We continued studies of the Medicare program, focusing on the growth in spending for Medicare physician services. Despite current policies that attempt to control the overall growth in Medicare physician spending, a study published in the New England Journal of Medicine showed that expenditures had grown much more rapidly for imaging service and procedures than for office visits. We noted that such spending patterns should be considered in the program's cost control policies. The House of Representatives passed legislation that reflected these proposals, but they have yet to become law.