Publications on Uninsured/Uncompensated Care

This report estimates the benefits and costs of alternative forms of state-funded medical reinsurance in Washington using the Urban Institute's Reinsurance Model. A subsidy targeted at all small firms would substantially increase primary coverage but would be very expensive, as most benefit would flow to already insured people. Targeting the conventional small group market by excluding association health plans would reduce state cost per newly uninsured person and would bolster existing regulatory requirements for that sector;s insurers to use modified community rating. Any practical program also needs to identify secure funding and maintain cost consciousness among newly reinsured health plans.

In 2005, the Hilton Foundation gave CSH a five-year grant to launch an initiative in Los Angeles County to reduce the number of long-term homeless people, with a special focus on people with serious mental illness. The Urban Institute, which is evaluating the grant's impact, did a baseline assessment of homelessness and permanent supportive housing in 2005. A 2007 report assessed the policy and system changes that, working with others, CSH efforts had stimulated by that time. This report documents two-year changes in the level of homelessness in Los Angeles and the availability and characteristics of PSH availability. A second policy report will be available in fall 2008.

The Los Angeles Healthy Kids program, during its first four years, extended comprehensive, affordable coverage to over 40,000 poor and vulnerable children, and improved their access to and use of care. Yet, the program also faced serious challenges, primarily related to financing. Funding for children ages 6 through 18 ran short in spring 2005 and Healthy Kids capped their enrollment. State health reform efforts that could have stabilized funding for the program have failed. Based on interviews with over 40 stakeholders, this case study analyzes the complex challenges that the Los Angeles Healthy Kids program faces at this critical juncture.

With health reform at the forefront of the national campaign, some charge that proposals to restructure our health care system represent dangerous steps moving the country towards government-run health care and socialized medicine. Similar rhetoric was heard last fall when President Bush vetoed legislation reauthorizing the State Children's Health Insurance Program (SCHIP). We find this rhetoric inapplicable to both the SCHIP bill and proposals from most presidential candidates. The core issues in health reform involve, not the size of government, but proposals' effect on the number of uninsured, access to quality care, cost growth, and consumers' health care choices.

This forum explores the meaning and implications of the arguments about socialized medicine. A new paper from the Urban Institute's John Holahan and Stan Dorn examining the issue serves as a springboard for a lively conversation.