HEALTH COVERAGE: Reforms Haven’t Halted Insurance Gap
Despite economic prosperity and far-reaching -- although not comprehensive -- legislative health measures, the number of uninsured Americans has risen by approximately 1 million per year since 1987, to 41 million. A front page story in Sunday's New York Times reports that the benefits of the "two significant health care laws since the collapse of the Clinton plan" -- the Kassebaum-Kennedy health insurance portability law and the Children's Health Insurance Program (CHIP) to provide subsidized coverage for low-income children -- have largely been nullified by loopholes, enforcement problems, and changes in other programs such as welfare. The Times reports that:
- "[I]nsurance companies have found ways to skirt the Kassebaum-Kennedy law by shunning people with medical problems or by charging them very high premiums."
- "[T]he federal government is supposed to enforce [Kassebaum-Kennedy] directly, but the Clinton administration acknowledges it was unprepared for this immense new responsibility."
- "Sweeping changes in federal welfare policy may inadvertently increase the number of uninsured children, offsetting some of the expected gains in coverage from" CHIP.
The Times reports that there is no consensus on how to extend insurance coverage, except "not to repeat the mistakes that killed Mr. Clinton's plan." Sharp ideological divides pose a problem: "Republicans are philosophically opposed to price controls" while "liberal Democrats continue to push legislation that would require employers to provide coverage," a proposal that is "anathema to conservatives in both parties." The only agreement is that a crisis exists, but neither party can "find the money for the subsidies that would be needed to make insurance truly affordable to millions of low-income Americans." Sen. Paul Wellstone (D-MN), who recently introduced legislation that would provide states with "large sums of federal money" for universal coverage programs, said, "Here we are at peak economic performance, and we are being told that we cannot provide health coverage for everyone. If not now, when?" Drew Altman, president of the Henry J. Kaiser Family Foundation, said, "This is the biggest problem we face in American health care, and it's not on the political agenda. ... We have been making some progress with the small incremental reforms, but it's like shoveling sand against the tide" (Pear, 8/9).