In this report the authors estimate that under the health reform bill passed by the Senate, the cost of uncompensated care will fall from $62.1 billion in 2009 to $46.6 billion in 2019. If no health reform is enacted, they project that uncompensated care would rise to between $107 and $141 billion in 2019. Over the six-year period of proposed health reform legislation, 2014–2019, the costs of uncompensated care without health reform would be between $560 and $700 billion. With reform, the cost would be $330 billion under the Senate bill and provide substantive savings to each level of government.
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Both the Senate and House health reform proposals will dramatically reduce the number of uninsured as well as the amount spent on uncompensated care. If health reform is not enacted, the number of uninsured will increase significantly, as will uncompensated care burdens. We estimate that the cost of uncompensated care will fall from $62.1 billion in 2009 to $46.6 billion in 2019 under the Senate bill, and to $36.5 billion in 2019 with the House bill. The impact on uncompensated care of the large reductions in the uninsured is somewhat offset by increases in health care costs. Without reform, the cost of uncompensated care will increase to between $107 and $141 billion in 2019, depending on growth in the economy and health care costs. We estimate that from 2014 to 2019, uncompensated care costs would be $330 billion with the Senate bill and about $240 billion under the House bill. In contrast, the cost of uncompensated care over the same period without reform would be between $560 and $700 billion. The budget implications for state and local governments are substantial.
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