How reform will affect America, group by group

In Health Affairs (AHCJ members get free access), economist Joseph Newhouse considers how health care reform will affect four major groups. They’re summarized below.

  • Uninsured or on Medicaid or CHIP (30 percent)
  • Medicaid expansion and broader subsidies are “major gains.”

  • Insured individually or through a small business (10 percent)
  • This group will undergo the most change, with the individual mandate expanding their ranks to as much as 50 million people (16 percent of Americans). Health reform should “repair” this now-broken sector of the market.

  • Insured through a mid-size or large business (45 percent)
  • A wash, as an insurance tax is balanced out by a reduced need to cover uncompensated care for the uninsured.

  • Recipient of Medicare (15 percent)
  • Complicated. The doughnut hole will close, but future financing sources are murky. Newhouse goes pretty deep into just how murky.

His conclusion is relatively upbeat. Newhouse writes that while reform “addressed many issues in health care financing, it left many others unresolved.” The system will need to be revised and updated throughout the foreseeable future, Newhouse writes, and effective implementation will “require persistence for many years to come.”

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