More coverage for less cost not 'politically feasible', health reform study indicates

Options existed for health reform that could have either lowered federal spending by $20 billion per year without decreasing the number of newly insured citizens or increased coverage to 4 million Americans at no cost, according to an article recently published in the journal Health Affairs. However, none of the other scenarios investigated were considered reasonable politically, an analysis from the RAND Corporation determined. 

A total of 2,016 different scenarios for health reform were reviewed using RAND COMPARE, a simulation tool directed by RAND Corporation researchers Elizabeth McGlynn and Jeffrey Wasserman. On average, according to McGlynn, this study's lead author, all newly insured citizens experienced a "net positive financial benefit." 

In the scenario lowering annual spending by $20 million, the nation's poorest citizens would be required to shoulder more of a financial load. Adding 4 million people to the 28 million already expected to receive coverage in 2016 would mean increasing noncompliance penalties from $750 to $1,200 per year. 

"All of these strike us as politically difficult, if not untenable," McGlynn wrote. "Thus, on balance, the new law appears to have landed on a distinctive plain of the policy frontier, where costs and coverage levels achieved were reasonable and passage of the law was politically feasible." 

To learn more:
- read this Health Affairs abstract (full article available with subscription)
- check out this RAND Corporation press release

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