Overview

Americans receive their health insurance through several different sources and types of coverage. The majority of non-elderly Americans receive health coverage through their employer. Medicare covers nearly all of the elderly in the country, and Medicaid and the State Children's Health Insurance Program (SCHIP) provide coverage to millions of low-income and disabled adults and children.

However, gaps in coverage remain a challenge for policymakers. Nearly 47 million Americans lacked health insurance in 2005, and a majority of them come from working families with low and moderate incomes.

The lack of insurance results in less preventive care, a higher probability of hospitalization for treatable health conditions, and later diagnosis of disease. Each of these factors adversely impacts the well-being of the uninsured and adds to the costs of uncompensated care for which hospitals, providers, local and state governments, and the federal government ultimately will be responsible.

States have taken various actions in order to decrease the number of the uninsured and to control the volume and cost of uncompensated care being delivered in the state. States are using various strategies to address the problem of the uninsured, including:

• Expanding private group coverage via the employer-sponsored system through tax credits, premium assistance programs, and Medicaid and SCHIP waivers;
• Offering new, affordable insurance products through the private market with state-required benefit packages;
• Reforming Medicaid through new flexibility offered by the recent Deficit Reduction Act or through the traditional method of Section 1115 waivers;
• Expanding SCHIP eligibility and benefits; and
• Strengthening the safety net of clinics and physicians serving the uninsured.

Focus of Center Activities

The NGA Center for Best Practices is focusing on the following activities:

• Report on trends in health insurance coverage and costs;
• Synthesize and disseminate information on state best practices to increase health insurance coverage and contain costs;
• Provide technical assistance and consultation to states as they develop and implement new programs; and
• Track and report on state efforts to provide pharmaceutical benefits to the elderly, disabled and uninsured.