In 2000, the Lewin Group — a health care policy research and management consulting organization based in Falls Church, Va. — developed cost and coverage estimates of eight different proposals to expand health care coverage.

Key Findings

• Five proposals offered incremental changes to current methods of health coverage:
  • Expanded eligibility for Medicaid and the State Children's Health Insurance Program (SCHIP).
  • New tax credits for individuals, vouchers to subsidize premiums and tax credits for small employers.
  • Vouchers to subsidize premiums and tax credits for small employers.
  • Expanded tax subsidies for purchasing health insurance.
  • Expanded high risk pools for people whose pre-existing conditions limit their access to insurance.
• Three proposals offered system-wide changes, including replacing the current employer-based system with income-based tax credits for purchasing private health insurance and requiring universal health insurance.
• None of the incremental plans reached more than 40 percent of the 48 million people expected to be uninsured in 2001.
• The number of people covered ranged from 13 million under the most highly incremental proposal to 286.9 million under the broadest system-wide reform proposal.
• The incremental reform proposals with the greatest effect on coverage combined mandatory expansions of Medicaid/SCHIP eligibility for poor people with subsidies to other low-income people to help them purchase private insurance.
• Costs reflected the extent to which proposals reduced the number of uninsured people: from $19.6 billion to reduce the number of uninsured people by 7.3 million, to $453.9 billion to reduce the number of uninsured by 48 million people.

Funding
The Robert Wood Johnson Foundation (RWJF) supported this project through two grants totaling $148,250.