States that pass laws to increase access to health insurance for the uninsured too often only make matters worse, according to many health-care analysts.

• A study last year by the Galen Institute revealed that 16 states had passed aggressive laws between 1990 and 1994 designed to increase access to health insurance for their uninsured populations.

• But by 1996, those states had an average annual growth in the ranks of the uninsured eight times that of the other 34.

Tennessee led the way in adopting a radical reform -- known as TennCare. Here's how that controversial policy backfired:

• The 1993 legislation was supposed to cover 800,000 poor people on state Medicaid, plus 400,000 uninsured and uninsurable -- for less money than Tennessee was spending on Medicaid.

• It would do so, officials promised, by putting them all under managed care.

• But costs skyrocketed because of an explosion of the number of uninsured people included on TennCare's rolls.

• TennCare says it provides insurance for some 114,000 uninsurable people -- but high-risk pools in the other 27 states total only 100,000 uninsurables combined.

That number includes California's high-risk pool, which covers 21,400 people. Experts are asking how it can be that Tennessee -- which has one-sixth of the population of California -- has five times as many uninsurables.

Because the program now consumes one-quarter of the state's budget, lawmakers are seriously considering adopting a state income tax for the first time -- just to pay the medical bills.

Source: Editorial, "California Dreaming," Investor's Business Daily, October 22, 1999.

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