60 million uninsured!

[pickledpepperRN]

http://www.nytimes.com/2003/05/13/health/13HEAL.html

May 13, 2003

New Study Finds 60 Million Uninsured During a Year

By ROBERT PEAR

ASHINGTON, May 12-Nearly 60 million people lack health insurance at some point in the year, the Congressional Budget Office said today, adding that official estimates fail to distinguish between people who lack coverage for a few months and those who are uninsured for a full year or more.

Members of Congress, administration officials, lobbyists and advocates often cite the Census Bureau when they declare that 41 million people have no health insurance.

But in a new report today, the budget office said the bureau's figure "overstates the number of people who are uninsured all year," while significantly understating the number who are insured for only part of the year.

The report said 57 million to 59 million people, "about a quarter of the nonelderly population," lacked insurance at some time in 1998, the most recent year for which reliable comparative figures were available.

At the same time, the budget office said, government surveys suggest that the number of people uninsured for the entire year was 21 million to 31 million, or 9 percent to 13 percent of nonelderly Americans.

The widely used figure from the Census Bureau is based on interviews conducted by the government, as part of the Current Population Survey, in March of each year. The questions about insurance are meant to identify people who were uninsured for all the prior calendar year.

But the budget office said that many people "report their insurance status as of the time of the interview, rather than for the previous calendar year as requested."

The new research confirms what some economists and health policy experts had suspected for years: that it is difficult to count the uninsured because people are continually losing and gaining coverage, and they do not always understand the questions asked in government surveys.

Douglas J. Holtz-Eakin, the new director of the Congressional Budget Office, said: "Far from being a static group, the uninsured population is constantly changing. While many people are chronically uninsured, many more are uninsured for shorter periods of time."

In writing legislation to expand coverage, Mr. Holtz-Eakin said, members of Congress must "consider the distinction between the short-term and long-term uninsured."

Lawmakers have proposed several approaches. Republicans and some Democrats want to offer tax credits to help individuals or small businesses buy private insurance. Many Democrats want to expand Medicaid, the federal-state program for low-income people, or the Children's Health Insurance Program.

Some Democrats, including Representative Richard A. Gephardt of Missouri and Senator Edward M. Kennedy of Massachusetts, want employers to provide coverage to employees, with government subsidies.

The budget office conducted its study at the request of Representative Bill Thomas, the California Republican who is the chairman of the Ways and Means Committee.

Mr. Thomas said the report offered "some good news: fewer individuals are long-term uninsured than previously thought."

But Senator Jeff Bingaman, Democrat of New Mexico, said: "The report underscores how big a crisis our country is facing. On any given day, more than 40 million Americans live with the prospect of facing financial ruin in order to pay for their health care, or going without care altogether."

One question the budget office addressed was how long people go without coverage when they are uninsured. For some, the experience is relatively brief. But others go more than two years without insurance.

The office focused on people who became uninsured from mid-1996 to mid-1997 and tracked them for several years. It found that 45 percent were uninsured for four months or less, 26 percent were uninsured for 5 to 12 months, and 13 percent lacked coverage for 13 to 24 months, while 16 percent were uninsured more than two years.

[sjoe]

"The report said 57 million to 59 million people, "about a quarter of the nonelderly population," lacked insurance at some time in 1998, the most recent year for which reliable comparative figures were available. "

1) so long as these people schedule their illnesses and injuries to coincide with times covered by insurance--no problem.

2) five-year-old numbers is the best these people at the CBO can do? THEY all have full health insurance coverage, of course.

[pickledpepperRN]

Good points sjoe!

[pickledpepperRN]

Bush Cuts Would Result in Millions Losing Vital Health Care Coverage

Families USA

Tuesday 13 May 2003

President's Medicaid Proposal Will Result in Nearly Half a Trillion Dollar Cutback in Funding

As Congress debates whether additional funding should be given to states to help pay for their cash-strapped Medicaid programs, a report issued today reveals that the Bush Administration's alternative to such funding would cause millions of seniors, children, and people with disabilities to lose health coverage. According to the report, the Bush Administration's alternative proposal-which would convert Medicaid to a block grant-would result in an almost half a trillion dollar loss of public health funds over the next 10 years.

The report, prepared by the health care consumer organization Families USA, finds that the Bush Administration's proposal would cause large funding cutbacks in Medicaid and the State Children's Health Insurance Program (SCHIP). The cutbacks would grow in each passing year. For example:

*In 2004, Medicaid and SCHIP funding would be cut by $8 billion, or 3 percent.

*In 2009, the funding reduction would be $49 billion, or 10 percent.

*By 2013, the cutback would be $105 billion, or 16 percent.

In total, over the next 10 years, Medicaid and SCHIP funds would be cut by $492 billion under the Administration's proposal.

"The Bush Administration's proposal would slash the funds needed to sustain needed health services for America's seniors, children, and people with disabilities," said Ron Pollack, executive director of Families USA. "It would result millions losing their health lifeline."

The Administration's proposal would radically alter how Medicaid is funded. Today, the federal government provides matching funds for every dollar a state spends on Medicaid. The federal government pays states between $1 and $3 for every $1 a state puts into Medicaid. Through this system, states are guaranteed a very favorable match in federal funds for every dollar committed to the program.

Under the Bush plan, the federal government would establish a set amount that a state must spend on Medicaid in order to receive a cash allotment from the federal government. The amount states would have to spend in order to receive federal assistance would be considerably less than they are projected to spend under current law. Therefore, states would have no incentive to commit resources above the amount specified because no additional federal funds would be provided as a match. The Families USA report calculates the resulting loss in funding.

At the end of the 10-year funding period (in 2013), the Medicaid and SCHIP programs would be cut by 16 percent. By applying this 16 percent cutback to today's Medicaid program, the Families USA report illustrates how these cuts could affect seniors, children, and people with disabilities. If this 16 percent cutback were applied today in across-the-board reductions in program eligibility:

* Almost 7.5 million people would lose health care coverage. * Nearly 3.9 million children; over 1.2 million people with disabilities; almost 690,00 seniors; and approximately 1.7 million other adults would lose health coverage.

The report-including state-by-state data concerning funding cutbacks and potential losses of health coverage for seniors, children, people with disabilities, and others-is available on the Families USA Web site at http://www.familiesusa.org.