View Research by Author - Michael S. Sparer

Publications

The author contends that the health insurance system in Arizona is in the midst of a crisis. At the beginning of the decade, roughly 21 percent of the state's population was without health insurance. By 1997, that number was up to 28 percent, the highest in the nation, despite the state's strong economy and low rate of unemployment. The author argues that the state's economy is driven by service-sector jobs that offer employees relatively low pay and frequently do not offer health insurance or other benefits. Arizona is also the only state in the nation that requires all Medicaid beneficiaries to receive long-term services from Managed Care companies. The author describes the impact of the states effort to introduce more health plan competition into this program.

The author contends that Oregon is a leader in the effort to guarantee low-income residents access to affordable health insurance. State policies contributed to a rapid decline in the number of uninsured residents. Oregon's long-term care system is also a national model. It ranks first in the nation in its commitment to home- and community-based services. Despite these achievements, the report finds three future challenges facing the state: it must address the recent rise in uninsured residents; the withdrawal of several commercial HMOs from the Medicaid market may be cause for concern; and the maturation of Oregon's innovative long-term care system may create new challenges.

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