NCPA - National Center for Policy Analysis


January 5, 2010

The Senate health care reform bill (HR 3590) would cover 94 percent of U.S. residents and extend benefits to 31 million more people by 2018, but the Congressional Budget Office (CBO) has projected that as many as 23 million people younger than age 65 still would be left uninsured under the legislation.  This finding has drawn comparatively little attention, in part because a large portion of the group would include younger people who consider themselves healthy enough to go without coverage even if they can afford it, according the Washington Post.

  • CBO has not provided information on specific demographics that would make up the 23 million people, but about one-third of the group are expected to be undocumented immigrants.
  • Neither Democrats nor Republicans favor extending coverage to this population through Medicaid or government subsidies, and a provision in the Senate bill would ban such benefits.

According to the Post:

  • The group of uninsured also could include people who are eligible for Medicaid coverage but do not sign up, as well as people who would be exempt from the bill's individual coverage mandate if the cost of insurance exceeds more than 8 percent of their income.
  • Under the Senate bill, documented U.S. residents would be required to pay financial penalties beginning in 2014 if they fail to obtain some type of health coverage.

Final health reform legislation is expected to closely resemble the Senate bill, even though the House bill (HR 3962) would expand coverage to 36 million more people and cut the number of uninsured down to 18 million through higher subsidies for low-income groups, and larger penalties for employers and individuals who fail to provide or obtain coverage.  The House bill costs more than $1 trillion, compared with $871 billion for the Senate bill.

Source: Perry Bacon Jr., "Senate health care bill would still leave millions uninsured," Washington Post, January 2, 2010.

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