Forty-five million nonelderly Americans were uninsured in 2007, and that was before the recession wiped out scores of jobs. Most laid-off workers likely lost their health insurance along with their incomes, and private coverage costs too much for many families to buy. And as medical costs soar, the price tag on promised Medicaid benefits is reaching unsustainable levels. These distress signals have put health care reform high on the president’s and policymakers' agendas. Read more.
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healthpolicycenter.org UI's resource for health policy-related research, commentary and testimony
In 2006, the Corporation for Supportive Housing launched its Returning Home Initiative (RHI) with two goals: 1) to establish permanent supportive housing as an essential reentry component for formerly incarcerated persons with histories of homelessness, mental illness, and chronic health conditions; and 2) to promote local and national policy changes to integrate the corrections, housing, mental health, and human service systems. The Urban Institute assessed the process of system change stimulated by RHI activities in New York, Los Angeles, and Chicago—three communities receiving significant RHI investment. This brief summarizes the influence of RHI-funded activities in each of these cities.
The Cato Institute recently released a study of health reform in Massachusetts by Aaron Yelowitz and Michael F. Cannon, entitled "The Massachusetts Health Plan: Much Pain, Little Gain." That study reports fewer gains in health insurance coverage and higher costs than have been reported by earlier studies. As the Urban Institute has done a substantial amount of research on health reform in Massachusetts, we have received a number of requests to reconcile the findings on health insurance coverage from the Cato study with the findings from earlier work. This paper is a response to those requests.
Institute Fellow Rudy Penner describes how the U.S. budget is prepared by the executive branch and Congress, and how it then is implemented by the executive branch. The budget preparation process could be improved, Penner asserts, but budget implementation works smoothly and efficiently. The severe long-run budget problem the country faces is caused by only three spending programs: Social Security, Medicare, and Medicaid. All are growing faster than the economy, and there is strong opposition against raising tax burdens. Changes are suggested for the budget process so that it is better suited for dealing with this long-run problem.
In this brief, we estimate that the annual cost of uncompensated health care for the uninsured would decrease from $61 billion to $25 billion under health reform legislation passed in the House. Because the government finances about three-quarters of uncompensated care, up to $27 billion per year could be used to offset the expansion of Medicaid and subsidies to employers and individuals. Overall, employers' net costs would increase by 2.9 percent over the current system, but small employers' net costs would decrease 8 percent due to employer subsidies, the expansion of Medicaid, and exemptions from penalties for not offering insurance.
Using the current House health care reform bill (H.R. 3962) as our analytic framework, we have updated our earlier age rating analysis, providing comparisons of the distributional implications of 3:1, 2:1, and 1:1 (no age variation, pure community rating) rating. We summarize the implications of the rating rule decision for insurance coverage, the costs (government and private) associated with reform, and the implications for household financial burdens. The analysis shows that, in the context of comprehensive health care reform, choice of premium rating rules applied to health insurance coverage has significant implications for the distribution of financial burdens.
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