Health care bills could leave millions uninsured

The cost of health insurance could hinder President Obama's goal of achieving universal coverage.

"The high cost of health insurance premiums would continue to put coverage out of reach for millions even if Congress approves legislation President Obama says is intended to ensure 'that every American has affordable health care,'" USA Today reports. "The number of people who remain uninsured will depend on how House and Senate leaders reconcile separate versions of health care legislation to arrive at a final bill. The factors include the size of government subsidies to help low-income families pay for insurance and the scope of penalties that would be charged for those who don't buy a plan." According to a Congressional Budget Office analysis, 17 million Americans would remain uninsured under the Senate Finance Committee's 10-year, $829 billion health care bill," including many "families who earn too much to qualify for Medicaid but not enough to pay for insurance. Others who could remain uninsured under the Finance Committee bill include people who choose to pay a proposed $750-a-year fine rather than buy coverage and those who are eligible for Medicaid but don't enroll" (Fritze, 10/26).

The Washington Post reports that "the question of whether people will follow a government order that they carry health insurance -- an issue that will help determine whether universal health care is a success or costly failure -- will depend on more than the penalty they would pay for refusing, many economists say. This, they say, is the lesson of behavioral economics, a school of thought that holds that people do not necessarily make decisions out of well-reasoned self-interest. It is an approach that has gained a powerful foothold in the Obama White House."

Behavioral economists say that "compliance will depend not only on the penalties and cost of coverage, but also on the ease of signing up for coverage and whether people can be persuaded that it is a widely accepted social norm. They point to the large number of eligible people who fail to take advantage of Medicaid, food stamps and Pell grants as a sign that perceived inconvenience can keep people from taking steps in their economic interest" (MacGillis, 10/26).

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This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.