Despite a series of reports showing a continuing growth in the number of Americans without health insurance coverage, some healthcare experts said they don't expect Congress next year to seriously consider any new government initiatives to reverse that increase.
President Clinton may propose expanded coverage for retirees age 55 to 64 and temporarily unemployed workers, but Congress is more likely to respond to voter anger by pushing patient protection and quality legislation to the top of its healthcare agenda, experts say.
Before it acts again to expand coverage, Congress may wait to see the effect on coverage of health insurance reform legislation passed in 1996 and a five-year, $24 billion children's health initiative.
As for the early retirees, a House Republican aide said Congress will want to wait for the long-term Medicare commission to report back in March 1999 before taking any steps related to covering older workers.
Meanwhile, Congress has never acted on Clinton's past proposals to cover temporarily unemployed workers, suggesting that members are not enthusiastic about those proposals.
The proposed 25-year, $368 billion settlement between tobacco companies and the state attorneys general, however, may provide an opportunity for Congress to finance some expansions of healthcare coverage.
"I think the tobacco settlement, if there is one, is the wellspring for the advance of any type of coverage," said Ron Pollack, executive director of Families USA, a national healthcare consumer organization.
The comments by healthcare experts came following the release of a survey by the Kaiser Family Foundation and the Commonwealth Fund showing that one-third of adults between ages 18 and 64 are uninsured or have been uninsured sometime in the past two years.
Of the uninsured adults, 57% were full-time workers or married to full-time workers, the study found. More than half of workers making less than $20,000 were uninsured or had been uninsured at some time in the past two years.
The Kaiser/Commonwealth survey is the latest in a succession of reports painting a bleak portrait of healthcare coverage in the U.S., including a recent U.S. Census Bureau report showing that the number of uninsured climbed by 1 million between 1995 and 1996, to 42 million.
Kaiser and Commonwealth said the findings suggest that low-wage workers should be a focus of any coverage expansions. Jack Bresch, a lobbyist with the Catholic Health Association, agreed that coverage of low-wage workers needs to be increased, but he added that it will be a difficult battle because there are so many uninsured poor workers.
"I think we're getting into the core of the problem when we're getting into the working uninsured," Bresch said.