Health Policy Center Authors

Publications by Aimee Williams for Health Policy Center

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In this paper and brief, the authors discuss alternative ways that health reform could be financed. They analyze different options including several proposals for delivery system reforms and for reduction in Medicare and Medicaid payments. They estimate the cost savings that could occur due to the introduction of a public plan option. Finally, they explore a range of revenue options. The key message of the paper is that health reform can be paid for, but it is best to obtain funds from a large number of measures to spread the burden broadly.

Medicaid physician fees increased 15.1 percent, on average, between 2003 and 2008. This was below the general rate of inflation, resulting in a reduction in real fees. Only primary care fees grew at the rate of inflation--20 percent between 2003 and 2008. However, because of slow growth in Medicare fees, Medicaid fees closed a small portion of their ongoing gap relative to Medicare--growing from 69 percent to 72 percent of Medicare. The increase in Medicaid fees relative to Medicare fees resulted from relative increases for primary care and obstetrical services, but not for other services.

A new analysis conducted for the Kaiser Family Foundation's Commission on Medicaid and the Uninsured examines the implications of a downturn for health coverage and state programs. The authors estimate that a one percentage point increase in the national unemployment rate would increase Medicaid and SCHIP enrollment by 1 million and cause the number of uninsured to grow by 1.1 million. The analysis documents how federal fiscal relief during the last economic downturn of 2003-2004 helped to stabilize Medicaid eligibility and let states avoid deeper budget cuts. The authors also consider alternative approaches to targeted federal fiscal stimulus.

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