Growth in uninsured Americans outpacing federal spending on the healthcare safety net

Healthcare Financial Management, Dec, 2005

At a Nov. 4 policy briefing examining the latest health coverage trends and the implications for the nation's healthcare safety net, the Kaiser Commission on Medicaid and the Uninsured profiled the growing uninsured population and portrayed the healthcare safety net as increasingly straining to meet uninsured people's needs.

New analysis highlighted found that, as the number of uninsured Americans increased by 4.6 million from 2001 to 2004, federal safety net spending per uninsured person fell from $546 to $498 during the same period. After adjusting for inflation, total federal spending for care for the uninsured increased by 1.3 percent from 2001 to 2004 while the number of uninsured increased by 11.2 percent. These trends resulted in an 8.9 percent decline in spending by the federal government per uninsured person.

The analysis of federal spending on the healthcare safety net, written by Jack Hadley and colleagues at The Urban Institute, describes the patchwork of federal money dedicated to care for the uninsured. The report documents that federal support for community health centers increased by more than 50 percent over the past four years, but still only accounts for less than 3 percent of total federal spending on the healthcare safety net. The authors noted that because more than 70 percent of federal support for the uninsured flows through Medicare and Medicaid, which are both under budgetary pressures, "it is unlikely that future funding will be able to close the gap or make up the difference" in the increase in the uninsured and funding for their care.

To read the policy briefing, go to www.kff.org/ uninsured/kcmu110405pkg.cfm.