Robert Wood Johnson Foundation

In January of 2000, the Robert Wood Johnson Foundation (RWJF) sponsored the "Health Coverage 2000" conference at which eight major health care organizations and associations introduced proposals to expand health insurance coverage. Some of those proposals were introduced as the next steps toward universal health coverage and two of them would incrementally phase in universal insurance coverage by the middle of this decade. The incremental reform proposals included various expansions of Medicaid and the State Children's Health Insurance Programs (SCHIP), changes in tax subsidies for insurance including modifying the current tax exclusions and/or introducing tax credits for health insurance, and expansion of high-risk pools. Lewin was asked to estimate the cost and coverage impacts of the eight proposals. Assuming full implementation in 2001, Lewin estimated that the incremental reform proposals would cost between $15.4 billion and $59.1 billion and would reduce the number of uninsured by 7.3 million to about 19 million persons. Therefore, the incremental reform proposals would cover no more than about 40 percent of the uninsured. The universal coverage programs would cost between $324 billion and $454 billion per year. The incremental reform proposals specified no new revenue sources to cover the cost of the programs. However, the universal coverage proposals did include new revenues that would cover most if not all of the costs of the programs.

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