If the US Congress fails to reform health care, states will spend more on their programs for the poor than they currently pay out, according to a new report on Wednesday. The Robert Wood Johnson Foundation report shows that within a decade the number of people without health insurance could increase by more than 30 percent in more than half of the states.
The uninsured are most likely to turn to public programs administered by the states. The Senate Finance Committee is hammering out a plan to make sure all Americans have access to affordable healthcare, a linchpin issue for President Barack Obama's administration.
Governors and state legislatures are concerned that the federal plan will allow more people to sign up for Medicaid, the health-care program for the poor that states manage with partial reimbursements from the federal government. The more who enroll, the more money states will have to spend, they say. At the same time, mandating everyone to have health insurance could force millions of people who usually forego coverage to choose Medicaid.
The foundation said that under the current system every state could see its spending on Medicaid and CHIP, a program for children of lower-income families, rise by more than 75 percent in 10 years; half could have their costs more than double. At the very least, 13 states would see the costs of those programs grow by more than 65 percent.
The foundation, which describes itself as is the largest healthcare-devoted philanthropy in the country, considered three scenarios based on the strength of the US economy in the next decade. In the worst-case scenario, it found that enrolment in Medicaid and CHIP, or Children's Health Insurance Program, would increase to 20.3 percent of the national population from the current 16.5 percent. In the best case, it would grow to 18.3 percent.
Even in that rosier scenario, fewer and fewer people would be covered by employer-sponsored insurance plans, which deliver most of the health care in the United States. That would leave a larger group to turn to Medicaid. "Medicaid and CHIP expenditures would grow substantially both because of increased enrollment and because of higher health-care costs," the foundation said.
Population growth will further impact enrollment. In Arizona, Florida, Nevada and Utah, the number of people with employee-sponsored insurance would grow over 10 years, but the proportion of people in those plans would shrink as the states' populations swell.
Ultimately, the foundation said, the cost of financing the public programs currently in place will create additional burdens for tax payers. "While enacting health reform will be difficult and expensive, the cost of failure is substantial and will be felt in every state," it said. Without a reform plan, businesses, too, will have to pay higher insurance costs, the report found.