Nashville News Blog

​Gov. Phil Bredesen is back in the headlines today denouncing health care reform as too costly for the states. (Well, at least he's doing that in today's Tennessean, which is running a few days behind the rest of the world on this one. The governor himself is on his way to China.) Anyway, Pith is wondering why Bredesen, the former HMO executive, never mentions the cost of failing to fix health care?

A new study by the Health Policy Center at the Urban Institute, a pro-reform group, breaks it down state by state, and it isn't pretty. According to the report's worst-case scenario, the number of people without insurance would increase over the next decade by more than 30 percent in 29 states, including Tennessee, and businesses would see their premiums double in 27 states, again including Tennessee.

Every state would see a smaller share of its population with employer-sponsored insurance. In 10 years only 45 percent of Tennesseans would be covered by their jobs, down from 52 percent now.

Every state would see its Medicaid/CHIP spending rise by more than 75 percent by 2019. Half the states, including Tennessee, would face cost increases of more than 100 percent.

And finally, the amount of uncompensated care in the health system would more than double by 2019 in 45 states, including Tennessee.

Here's the report's conclusion:

We conclude that without significant reform that makes health insurance more accessible and affordable and reduces the rate of health care cost growth over time, the number of uninsured will increase and health care spending will increase dramatically. Without reform, the cost of financing public program growth will place added burden on taxpayers. The rising cost of caring for a growing number of uninsured through safety net programs will also add to taxpayer burdens. Employers will face sharply increasing health care premiums. This will eventually get passed onto the workforce in terms of lower wages but that will not happen instantaneously. In the short-term, business profitability is adversely affected. Finally, individuals and families will face higher out-of-pocket costs for premiums and for services along with higher tax burdens.

We recognize that health reform itself will be costly. If enacted, government expenditures will increase by more than shown here because of increases in Medicaid enrollment and subsidies to low-income people--how much more depends on the cost containment provisions ultimately enacted. Employer spending will also grow, though it should be lower for small firms who have access to exchanges. Health reform will stem the continuous erosion in the number of Americans with health care coverage and reduce spending for a large number of lower income families. Reform will also decrease financial pressures on the hospitals and clinics that provide care to the uninsured, reduce many system inefficiencies, and ultimately improve the health and financial security of Americans. While enacting health reform will be difficult and expensive, the cost of failure is substantial and will be felt in every state.