Brief

While nearly half of U.S. physicians identify language or cultural communication barriers as obstacles to providing high-quality care, physician adoption of practices to overcome such barriers is modest and uneven, according to a new national study by the Center for Studying Health System Change (HSC).

This issue brief from Urban Institute examines various pathways through which individuals could gain coverage because of the health reform proposals that have passed the Senate and the House of Representatives.

The recession has significantly increased demands on the health care safety net as millions of people have lost jobs and health insurance, but in some cases the impact on safety net providers has been less severe than expected. That’s according to a new Center for Studying Health System Change (HSC) study of five communities—Cleveland; Greenville, S.C.; northern New Jersey; Phoenix; and Seattle.

The impact on spending by government and employers has been a major issue in the current health reform debate. Supported by the Robert Wood Johnson Foundation and prepared by researchers at the Urban Institute, this brief estimates the cost and coverage implications of the key provisions of the bill passed by the House of Representatives in November 2009.

The employer-based healthcare system has existed in America since World War II and is considered by many to be the bedrock of the nation’s health insurance system. To shore up this system and to extend coverage for those not currently insured, numerous health policy experts have argued for an “employer mandate” requiring employers to contribute to coverage for their workers.

With an estimated 29.3 percent of Americans age 19 to 29 lacking coverage, young adults are more likely to be uninsured than any other age group. Many policy-makers and advocates have ideas about how to insure this group, including enacting a federal statute to expand dependent coverage.

The concept of requiring people to acquire health insurance has drawn criticism from some on the right—who see it as a coercive intrusion by the federal government—and some on the left—who view it as a giveaway to insurance companies. Proponents of current legislation, however, view the individual mandate as both a necessary cost-control provision and a key step towards universal coverage.

Researchers from the Urban Institute review some of the key problems facing purchasers of insurance—whether they be individuals or employers—and outline whether and how a public health insurance exchange might address them.

The report also provides state-by-state estimates of the effects of the legislation on overall health insurance coverage rates (for both rural and urban persons), as well as estimates of how the previously uninsured would be covered under the provisions of the legislation.

The Urban Institute looks at how various health reform bills make the trade-off between government costs and affordability for low- and middle-income families.