Abstract

KIE: Some 37 million Americans are without health insurance, many of them the poor or the near poor. Two proposals to cover millions of these uninsured are examined to determine their financial impact on the public and private sectors. One proposal, which mandates an expansion of employer-provided insurance, would extend coverage to many of the working poor and their dependents. Costs of this expansion would be financed by the private sector, with the public sector affected by the loss of some jobs and tax revenues, and by reduced Medicaid expenditures. A second proposal allows the near poor, those with incomes just above the federal poverty level, to buy into the Medicaid program using their own funds and a public subsidy. The costs of this expanded coverage would be financed by the public sector. A combination of the two proposals would draw on private and public resources and provide health insurance to over 33 million presently uninsured Americans.