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The Health Care “Safety Net” in a Post-Reform World

The Health Care “Safety Net” in a Post-Reform World. Mark A. Hall Wake Forest University Sara Rosenbaum George Washington Univ. Other Authors. Robert W. Mickey, Univ. Michigan Thomas R. Oliver and Richard Rieselbach, et al., Univ. Wisc . Peter D. Jacobson, et al., Univ. Mich.

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The Health Care “Safety Net” in a Post-Reform World

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  1. The Health Care “Safety Net” in a Post-Reform World Mark A. HallWake Forest University Sara Rosenbaum George Washington Univ.

  2. Other Authors • Robert W. Mickey, Univ. Michigan • Thomas R. Oliver and Richard Rieselbach, et al., Univ. Wisc. • Peter D. Jacobson, et al., Univ. Mich. • Frank J. Thompson, Rutgers, Pub. Policy • Gloria J. Bazzoli and Sheryl Garland, Va. Cmwlth. • Jack Needleman & Michelle Ko, UCLA

  3. Alison Snow Jones, 1949 – 2011

  4. Challenges • Reform will reduce by the number of uninsured by more than half • But, newly insured will face access challenges • And, perception of no need for remaining uninsured, or not deserving of suppot • The composition of the remaining uninsured will change substantially

  5. UNIVERSAL ACCESS

  6. Safety Net Deficiencies

  7. Access without Insurance • Potential access: Structural measures • Enrollment Card • Primary care medical home • Referrals to specialists, Rx, hospital • Perceived access: • Still face greater barriers to care • But, feels like insurance coverage

  8. Realized Access: Utilization Measures

  9. Asheville: Annual Visits Per Nonelderly Adult

  10. Create a sense of community-wide need • Recognize unavoidable gaps in coverage for low-income eligibles • Include middle income people still facing “unaffordable” premiums • Consider fee sliding scale

  11. Duration of Uninsured Spells

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