Cost of Covering the Uninsured a ‘Worthwhile Investment,’ Health Affairs Study States

The cost of health coverage for all uninsured U.S. residents "may be relatively small or at least a very worthwhile investment" and would add at least 3% to 6% per year to total U.S. health care expenditures, according to a study published yesterday on the Health Affairs Web site, the Hartford Courant reports (MacDonald, Hartford Courant, 6/5). The study, sponsored by the Kaiser Commission on Medicaid and the Uninsured and written by Urban Institute researchers Jack Hadley and John Holahan, presented two cost estimates based on an analysis of the health care expenditures of lower- or middle-income individuals with private health insurance and those in public health insurance programs, such as Medicaid, from 1996 to 1998. The study found that private health coverage for uninsured U.S. residents would add $68.7 billion to total U.S. health care expenditures, compared to $33.9 billion for public health coverage (Hadley/Holahan, "Covering the Uninsured: How Much Would it Cost?" Health Affairs Web site, 6/4).

Researchers said that coverage for the uninsured through public health insurance programs would cost less because providers often receive lower reimbursements from the programs and because the programs often provide less extensive coverage. However, researchers said that the cost estimates do not include the $99 billion per year that the United States spends to provide care for the uninsured (Hartford Courant, 6/5). They added, "A potentially important implication of a comprehensive rather than incremental approach to covering all of the uninsured is that the existing public money already being used to pay for care received by the uninsured will be very difficult to capture or reallocate if insurance expansion is piecemeal. Providers treating the uninsured will be loath to relinquish their existing subsidies unless they are assured that everyone will be insured" ("Covering the Uninsured: How Much Would it Cost?" Health Affairs Web site, 6/4). Diane Rowland, executive director of the Kaiser Commission on Medicaid and the Uninsured, said, "This study shows that the direct cost of providing care to the 41 million uninsured would be less than the annual inflation in health spending -- 8.7% in 2001 -- but would still require a commitment of new resources in a time of fiscal deficits" (Hartford Courant, 6/5). The study is available online.