Key Principles for Covering the Uninsured

More than 43 million U.S. residents lacked health coverage in 2002 and unless private or public coverage programs expand, the number of uninsured could continue to rise over the next decade. To address this growing problem, the Institute of Medicine (IOM), with support from The Robert Wood Johnson Foundation, has been conducting a three-year study of the uninsured to assess and consolidate evidence about the health, economic and social consequences of uninsurance for those without insurance, their families, health care systems and institutions, and communities as a whole.

The sixth and final report in the IOM series, Insuring America’s Health: Principles and Recommendations, wwasill be released on January 14, 2004. This paper seeks to raise awareness and improve understanding by both the general public and policy makers of the magnitude and nature of the consequences of lacking health insurance. The study recommends principles to guide reform of the health care system and expand coverage to the uninsured, based both on the previous five reports and on new analyses of past and present efforts to reduce uninsurance. The report also seeks to demonstrate how those principles may be used to assess policy options, though it does not recommend a specific coverage strategy.

What are the key findings and recommendations of the report? What are the policy and political obstacles to expanding affordable health coverage? Will policymakers begin to tackle the issue this year and, if so, how?

To help address these and related questions, the Alliance for Health Reform sponsored a January 16, 2004 briefing with support from the Robert Wood Johnson Foundation. Panelists were: Shoshanna Sofaer, Baruch College, who chaired the IOM subcommittee that formulated the new report; Mary Grealy, head of the Healthcare Leadership Council; and Risa Lavizzo-Mourey, president of the Robert Wood Johnson Foundation and an IOM member. Ed Howard of the Alliance moderated the discussion.