O of the major social policy issues facing the United States in the first decade of the twenty-first century is the large number of Americans lacking health insurance. While other industrialized nations guarantee universal health care for their citizens, 47 million persons in the United States, or 18 percent of the nonelderly population (the elderly are universally covered under the Medicare pr...

A key idea in the great health reform debate of 2009 is that uninsurance and the high costs of medical care are linked. Covering uninsured patients will improve their health over time, goes the claim, which in turn will offset some of the costs of providing insurance to these patients. This is almost certainly true; the debate is over the magnitude of the offset savings. In their provocative ar...

Almost 4.7 million nonelderly adults and children of the seven million Californians who were uninsured for all or part of 2009 will be eligible for insurance as a result of last year's health care reform legislation, according to new data from the 2009 California Health Interview Survey (CHIS 2009). Eligible Californians will obtain coverage either through Medi-Cal or through subsidies to purch...

S AFETY-NET HOSPITALS (SNHS) PROVIDE A DISproportionate share of care to uninsured and Medicaid patients. Because they have few privately insured patients, SNHs cannot cover the costs of uncompensated care for the uninsured by charging higher fees to insured patients. As a result of the heavy burden of uncompensated care for the uninsured and inadequate Medicaid reimbursement rates, most SNHs h...

INTRODUCTION National studies of largely urban populations showed increased risk of traumatic death among uninsured patients, as compared to those insured. No similar studies have been done for major trauma centers serving rural states. METHODS We performed retrospective analyses using trauma registry records from adult, non-burn patients admitted to a single American College of Surgeons-cert...

INTRODUCTION Lack of health insurance is a barrier to medical care, which may increase the risk of diabetes complications and costs. The objective of this study was to assess the potential of the Affordable Care Act (ACA) of 2010 to improve diabetes care through increased health care access by comparing health care and health outcomes of insured and uninsured people with diabetes. METHODS We ...

IMPORTANCE Under the Affordable Care Act (ACA), states can extend Medicaid eligibility to nearly all adults with income no more than 138% of the federal poverty level. Uncertainty exists regarding the scope of medical services required for new enrollees. OBJECTIVE To document the health care needs and health risks of uninsured adults who could gain Medicaid coverage under the ACA. These data ...