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House Subcommittee Examines Health Coverage for the Uninsured

On February 28, the House Energy and Commerce Subcommittee on Health held a hearing to discuss affordable health care coverage for the uninsured. Subcommittee Chair Michael Bilirakis (R-FL) opened the hearing, saying that the “number of uninsured individuals has remained at an unacceptable high level, despite a strong economy and record levels of employment.” He added that the recent economic downturn should raise “real concern” that health care costs will increase. Noting the importance of federally funded programs such as Medicare, Medicaid, the State Children’s Health Insurance Program (SCHIP), and community heath centers, Rep. Bilirakis said that “we must do more” and urged the consideration of “innovative and flexible solutions.”

Ranking Member Sherrod Brown (D-OH) agreed, saying, “We would get more bang for our buck to expand public health programs like Medicare, Medicaid, and SCHIP,” adding, “All of us need health insurance. Those of us who are healthy should not abandon those who are not.”

Arthur Kellerman of the Institute of Medicine (IOM) detailed a recently released IOM report called, Coverage Matters: Insurance and Health Care, which addresses myths about the uninsured and the implications of a lack of health care coverage. Noting that one of the myths is that people without health insurance get the medical care they need, Mr. Kellerman said, “They are less likely to see a doctor, receive fewer preventive services such as blood pressure checks, mammograms and screening for colorectal cancer, and are less likely to have a regular source of medical care.”

Mary Grealy of the Healthcare Leadership Council told the subcommittee that her organization supports a three-pronged approach to reduce the number of uninsured Americans, which includes refundable tax credits to purchase insurance, improvements in Medicare and SCHIP, and increased efforts to increase awareness about the importance and availability of insurance. “It is critical to point out that there is no single answer, no one policy solution that will address the needs of more than 40 million uninsured Americans,” she said, adding, “Taking on this issue requires flexibility and a mix of targeted public and private solutions.”

Diane Rowland of the Henry J. Kaiser Family Foundation discussed the characteristics of the uninsured. “Of the 38.4 million Americans who were uninsured in 2000, 9.2 million were children and 29.3 million were adults,” she said, noting that young adults ages 19 to 24 have the highest rate of uninsurance of any age group. She also stated that nearly two-thirds of the uninsured come from low-income families earning less than 200 percent of the poverty level.

Noting that the recent economic downturn could erode health care coverage, Ms. Rowland said, “As health costs grow and the premiums for insurance rise, health coverage through the workplace is likely to become less available and more unaffordable for working families.” Additionally, “maintaining the gains in public coverage over the last decade, especially for children, may require additional federal financing assistance to the states in return for a commitment to maintain coverage at current levels.”

Robert Garcia de Posada of the Latino Coalition told the subcommittee that people of Hispanic origin have the highest uninsured rates. “Over one-third, or 34.2% of Hispanics were uninsured compared with only 12% for non-Hispanic whites,” he said, adding that Hispanic workers are “heavily concentrated in the service industry and in small business—working for firms that do not or cannot offer them health insurance coverage.”

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