Mandates would be essential to the success of insuring people under the Senate health reform bill, according to an analysis released by the RAND Corp..
Mandates key to widening coverage: RAND
The public policy think tank, releasing analyses of both the House and Senate reform bills plus a side-by-side comparison of the two bills, concluded that the Senate bill would cut the number of uninsured Americans to 25 million by 2019 (a 53% decrease, based on status quo projections) and increase overall national spending on healthcare by about 2% cumulatively between 2013 and 2019.
The legislation's individual mandate, however, would play the largest role in increasing insurance coverage; it alone would reduce the number of uninsured by 21.5 million, according to RAND. “In the absence of penalties for individuals who do not purchase insurance, 10 million more people would be uninsured,” the analysis stated.
Additionally, the bill's employer penalties and Medicaid expansions would reduce the number of uninsured Americans by 1.5 million and 8 million, respectively. The House bill would reduce the number of uninsured to 24 million, a 56% decrease, but increase national health spending by 3.3% over the same period. On average, “Both bills would result in higher health expenditures for the newly insured,” according to RAND researchers.
Nevertheless, newly insured consumers would face a lower risk of catastrophic expenditures and would benefit from increased use of healthcare services. Under both bills, the people expected to gain most are those who obtain insurance either through Medicaid or the proposed health insurance exchanges, the analysis concluded.
Both bills have been in limbo as Congress mulls its next steps on reform. Of late, more piecemeal efforts were being considered to work around the Democrats' loss of their filibuster-proof majority in the Senate.
The RAND research was funded by various sectors of the healthcare industry, including insurers.
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