Consequences of alternative programs to cover the uninsured in central southern states

The lack of health insurance represents a significant barrier to timely, preventive medical services. In addition, certain providers risk financial viability as their uncompensated care burdens worsen. These issues are particularly troublesome in southern states because the population is disproportionately represented by greater numbers of poor uninsured individuals. This study examines the consequences of three alternative proposals to reduce the number of uninsureds in five southern states. Program 1 raises the AFDC income eligibility threshold to the federal poverty level. Program 2 drops Medicaid categorical eligibility requirements in favor of a poverty-level income standard. Program 3 requires employers to insure all employees, and their dependents, who work 25 hours or more per week. Surprisingly, Program 1 produces a modest 16 percent reduction in the uninsured. Programs 2 and 3, however, reduce the uninsured population by 41 and 57 percent, respectively. Nonetheless, these last two programs reach very different income groups. Program 2 captures all the poor uninsureds whereas Program 3 includes 40 percent of this same population. From this analysis it is clear that a combination of these programs would be necessary to effectively cover the uninsured.