Universal Health Needs Political Will: NIHCM President

The president of the National Institute for Health Care Management Foundation (NIHCM) said universal health care coverage is a laudable goal, but the reality of obtaining it in American will be difficult without the political will of government and voters to help the nation’s childless adults.

Nancy Chockley told insideARM that low-income, childless adults make up more than half the nation’s uninsured population, yet there are few public assistance programs available to help them.

Chockley based her comments in part on a finding in a report she co-authored with Julie Schoenman and Bridget Murphy, called “Understanding the Uninsured: Tailoring Policy and Solutions for Different Subpopulations,”  ("Open Up Healthcare Coverage for Parents and Junior will get it Too," May 15).

The authors found that states have been allowed to expand Medicaid coverage to low-income childless adults since 2001. However, only seven states (Arizona, Idaho, Indiana, New Mexico, Oregon and Utah) offer such coverage, which is subject to enrollment caps, cost-sharing requirements or other eligibility limitations. 

In addition, more than 40 percent of uninsured adults who cannot afford insurance have incomes above the federal poverty level. Chockley said it will be difficult to find affordable solutions for these people without affecting insured people with comparable incomes.

“Our culture is generous,” Chockley said. “But its extends to children, not to (low-income) childless adults.”

Chockley said America can make progress toward universal coverage by getting more of the people eligible for public health insurance enrolled in programs, and by seeking out subsidies for low-income childless adults and parents. However, federal and state budget deficits will delay or halt many universal health coverage efforts, she said.

“Striving for universal coverage is laudable, but the reality puts us a great distance from the goal,” she said. “In economic hardship, states aren’t going to be reaching out to those not enrolled in public programs, let alone expanding coverage.”

The NIHCM is a non-profit Washington, D.C.-based think tank that promotes improvement in health care access.