This is a presentation for a report from the Robert Wood Johnson Foundation conducted by Urban Institute called Health Refom: The Cost of Failure.

1. Prepared for the Robert Wood Johnson Foundation
John Holahan, Bowen Garrett, Irene Headen, and Aaron Lucas
The Urban Institute
May 21, 2009
THE URBAN INSTITUTE

2. Three Economic Scenarios
Worst case: Slow growth in incomes, high growth rates
for health care costs
Intermediate case: Somewhat faster growth in
incomes, but a lower rate of growth for health care costs
Best case: Return to full employment in 2014, faster
income growth, even slower growth in health care costs
THE URBAN INSTITUTE

3. Increase in the Number of Uninsured
2009-2019
(in millions)
Intermediate Worst Case
70 Case 65.7
Best Case 62.2
60 57.0
Baseline
50 49.1
40
30
20
10
0
THE URBAN INSTITUTE
3

4. Employer Spending on Premiums
2009-2019
(in billions)
Best Case Worst Case
1000 $885.1 2009
900 2014
800 $740.6 2019
700 $624.7
$572.9
600
500 $429.8 $429.8
400
300
200
100
0
THE URBAN INSTITUTE
4

5. Change in Medicaid/SCHIP Spending for
Acute Care, Non Elderly
2009-2019
(in billions)
Best Case Worst Case
600 2009
$519.7
2014
500
2019
$403.8
400 $366.5
$320.4
300 $251.2 $251.2
200
100
0
THE URBAN INSTITUTE
5

6. Change in Spending on Uncompensated
Care For the Uninsured
2009-2019
(in billions)
Best Case Worst Case
160 $141.4 2009
140 2014
$106.6 2019
120
100 $92.3
$81.0
80
$62.1 $62.1
60
40
20
0
THE URBAN INSTITUTE
6

7. Medicaid/SCHIP Spending and Uncompensated Care
Costs as a Share of Income
2009-2019
(as percent of aggregate incomes)
Best Case Worst Case
7% 6.4% 2009
2014
6%
4.9% 2019
5% 4.4%
4.1%
4% 3.7% 3.7%
3%
2%
1%
0%
THE URBAN INSTITUTE
7

8. Individual and Family Spending
2009-2019
(in billions)
Best Case Worst Case
600 $548.4 2009
$476.2 2014
500
2019
$416.9
$392.3
400
$326.4 $326.4
300
200
100
0
THE URBAN INSTITUTE
8

9. Conclusions In all three scenarios:
 Private coverage decreases
 Public coverage increases
 Number of uninsured soars
 Public spending for
Medicaid/CHIP jumps
 Cost of uncompensated care
rises
 Employer spending on
premiums grows
 Costs shift to workers through
lower wages
9

10. But if we act, health reform Conclusions
can:
 Cover more Americans
 Stabilize the safety net
 Make care more
affordable for families and
businesses
10

11. This Slidecast is presented by the
Robert Wood Johnson Foundation
and the Urban Institute
For more information or to view the full report, go to
www.rwjf.org or www.urbaninstitute.org.
THE URBAN INSTITUTE
11