Friday, October 2, 2009

Doomsday Scenario with No Reform

What will happen if Congress fails to adopt health reform? This is highly unlikely, given that President Obama’s and the Democrats’ political destinies are tied to some sort of bill, however modest, passing.

Nevertheless, according to new report commissioned by the Robert Wood Johnson Foundation project and carried out by the Urban Institute, cost would be substantial.

In every state uninsured numbers would increase, employer-sponsored insurance coverage would erode, spending on public programs would balloon, and out-of-pocket healthcare costs for individuals and families might increase by more than 35 percent by 2019.

Researchers from the Urban Institute used a Health Insurance Policy Simulation Model to estimate how coverage and cost trends would change between now and 2019 if the health system is not reformed.

Under the worst-case scenario, within 10 years the number of people without insurance would increase by more than 30 percent in 29 states, while the number of uninsured could grow by at least 10 percent in every state and the number of uninsured Americans would reach 65.7 million. Businesses would also see their premiums continue to increase – more than doubling in 27 states.

Even in the best-case scenario, the study indicates 46 states would see employer premium costs increase by more than 60 percent, every state would see a smaller share of its population getting health care through their job, half of the states would see the number of people with employer-sponsored insurance fall by more than 10 percent and every state would see its Medicaid/Children's Health Insurance Program (CHIP) spending rise by more than 75 percent.

Even in the best case, uncompensated care would also increase by more than 50 percent in 48 states, the study indicated.

“While enacting health reform will be difficult and expensive, the cost of failure would be considerable for every state in the union and affect every community,” said John Holahan, director of the Health Policy Center at the Urban Institute and one of the report’s authors. “Even in the best scenario, the cost of state-funded programs will grow considerably. Without reform, taxes will likely have to increase significantly to pay for higher Medicaid costs and care for the additional uninsured.”

Dr. Richard Reece’s latest book, Obama, Doctors, and Health Reform ( is available at,, and for $31.95 (hardcover), $21.95 (softcover), and $6.95 (electronic)

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