How much health care for $1 trillion?

Jul 15 2009

USA Today asks what the additional $1 trillion cost of a health care overhaul (over 10 years) will actually buy. "Although the eye-popping price tag would help boost insurance coverage to 95% or more of the public, it's not enough to do everything advocates initially want.

The proposals being shaped in Congress - including the $1.042 trillion bill unveiled by House Democratic leaders Tuesday - offer subsidies to fewer moderate-income families than originally intended, bar most workers from choosing to leave their employer-provided plans and likely drive up Medicaid costs for states." The Congressional Budget Office estimates that "at the end of a decade, 15 million to 20 million would remain uninsured."

"Here's the squeeze for policymakers: Allow the price tag to grow much past $1 trillion and you risk losing the support of fiscal hawks in Congress and voters alarmed by the costs of stimulus spending and corporate bailouts. … On the other hand, cut back too far and you imperil the legislation's fundamental goal of giving everyone access to health insurance they can afford. That could undermine support from the strongest advocates for change." Health care proposals emerging from the House and Senate "envision three big-ticket items that would consume the lion's share of the money: subsidies to help low- and moderate-income Americans buy insurance on new health exchanges; a dramatic expansion of Medicaid to cover the poor; and incentives to encourage small businesses to offer health insurance to their workers" (Page, 7/15).

CNN examines increasing coverage as well as health costs overall:  "Health care is a $2 trillion-dollar-a-year industry that would have to expand to cover millions of people who are now uninsured. The president has some ideas for new efficiencies but most estimates suggest the total cost of caring for Americans would rise dramatically. Washington is already carrying record debt and would have to find a way to pay for it. One assessment by the Congressional Budget Office of the Senate Democrat plan estimated it would cost more than $1 trillion over 10 years and only provide coverage for about 16 million Americans. There's also the possibility that the impact of reform on many employers and virtually every wage-earner across the country will have a spillover effect on the economy as a whole, still lodged in recession" (Mann, 7/14).