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Drop in Uninsured Unlikely to Influence Health Care Overhaul, Experts Say

By Neda Semnani, CQ Staff

September 5, 2008 -- While new government figures show that a greater enrollment in public health programs has helped reduce the number of Americans without health insurance, experts said the data are unlikely to help make the case for expanding those programs as part of broader health care legislation next year.

According to recent data from the Census Bureau, 1.3 million more people had insurance in 2007 than in 2006, the first increase in the number of individuals with health insurance since 2000. During the same period, there was a slight dip in the percentage of people covered by private or employer-based health insurance, while 3 million more people received coverage through publicly funded health insurance programs.

Overall, most groups, including Hispanics and African Americans, witnessed a modest increase in the insured rate, with one major exception. The rate of uninsured non-citizens and foreign-born went up significantly from 2006 to 2007, with the number of uninsured in this group more than twice the uninsured rate in the broader population.

David S. Johnson, the Census Bureau's chief of Housing and Household Economics Statistics, which published the new figures, credits public programs like Medicaid and SCHIP for the increase in the insured, a trend experts believe may continue as employer-based coverage falls.

Analysts said the drop in the uninsured rate will have little influence in the broader discussion of health care legislation expected next year when a new president and Congress take office. The economic downturn and other budget priorities make it difficult for health care overhaul—a costly endeavor—to take center stage, they said.

"How much flexibility does the federal government have, given the declining economy and vast array of other problem areas? We have a lot of policy priorities. Health is an important one, but it's not the only one," said Joseph Antos, a health care scholar with the American Enterprise Institute, a conservative think tank. "Some kind of reform needs to happen . . . eventually. Gigantic reforms cost money. So 'eventually' may not happen in the first year or even in the first ten years of a new administration."

Mark McClellan, director of the Engelberg Center for Health Care Reform with the non-partisan Brookings Institution, said, "With the fiscal outlook so tight, the challenge will be finding new ways get costs down and coverage up, while filling gaps in quality."

Judith Solomon, a senior fellow at the left-leaning Center on Budget and Policy Priorities, said the report examines the period just before the economic downturn and "doesn't change what is the case for reform, it doesn't change the case for reauthorizing strong public programs," said Solomon, who specializes in Medicaid and the State Children's Health Insurance Program (SCHIP).

The trend of greater enrollment in public health programs may continue in the current economic slowdown, said Karen Davenport, director of health policy with the liberal Center for American Progress. "On the one hand, we're likely to see a greater insecurity in health coverage; on the other, a further up-tick in public coverage ... The report points out just how effective these programs are in catching people when they fall. It shows that the individual market alone doesn't work."

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