Cost and Coverage: The Impact of Implementing Various State Health Care Reform Proposals Nationally. Coverage Impact

06/01/2008

A national combined health care reform initiative modeled after the Massachusetts plan would reduce the number of uninsured by 39.4 million (Figure 11).  Over twenty million previously uninsured individuals would be newly covered with the premium subsidy, 7.4 million would gain coverage from Medicaid and SCHIP, and 11.7 million would gain private coverage despite not being eligible for subsidized or public coverage.  Approximately 100,000 individuals would become newly uninsured as a result of their employer dropping coverage.

  Change in Coverage
Figure 11. Changes in Enrollment under a Combined Reform Approach (in millions)
Number of People who take the Subsidy (< 300% of FPL)

23.3

   Previously uninsured

20.4

   Previously non-group

1.4

   Previously ESI coverage

1.5

Workers and dependents whose employer drops coverage a/

2.2

   Take non-group coverage

2.0

   Enroll in Medicaid/SCHIP

0.1

   Go uninsured

0.1

Take up ESI coverage

8.3

   Currently decline ESI who take it

5.2

   Previously ineligible workers now offered coverage

1.4

   Firms who start offering coverage

1.7

Net Reduction in uninsured

39.4

   Newly covered under Medicaid/SCHIP

7.4

   Newly covered people eligible for the subsidy

20.4

   Newly covered people ineligible for subsidy

11.7

   Uninsured from employer dropping coverage

(0.1)

   Uninsured from dropping non-group coverage

(0.0)

a/ Impact of insurance market reforms on employer coverage.

Source: Lewin Group estimates using the Health Benefits simulation model (HBSM).

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