Task Force on Covering the Uninsured

The NCIOM Task Force on Covering the Uninsured focused its work on expanding health insurance coverage to the two groups most likely to lack coverage—small employers, low-income families—and to those with pre-existing health conditions. The recommendations concentrate in three areas: (1) subsidies and new insurance products aimed at making health insurance more affordable to small employers, (2) a Medicaid limited benefit package for low-income adults, and (3) a high-risk pool for people with pre-existing health problems. The Task Force tried to balance the need to provide health insurance to more uninsured with the necessity to restrain new health spending for employers, uninsured individuals and families, and government. Thus, many of the recommendations include limited benefit packages and/or cost sharing to ensure that, to the extent possible, uninsured individuals and families contribute toward the cost of their own care.
Full Report | Chapters | 2008 Update
Co-Chairs
The Honorable Carmen Hooker Odom
Secretary
NC Department of Health and Human Services
Thomas Lambeth
Senior Fellow
Z. Smith Reynolds Foundation
Task Force on Covering the Uninsured

The percentage of people without health insurance coverage is growing at a faster rate in North Carolina than in most of the rest of the country. Currently, more than 1.4 million non-elderly North Carolinians lack health insurance coverage, an increase of almost 300,000 since 2000. Most of the increase in the uninsured is attributable to the decline in employer-sponsored insurance. The rising cost of health insurance has made it more difficult for employers to offer and individuals to afford health insurance coverage.

The NCIOM Task Force on Covering the Uninsured was part of a larger planning effort to examine options to expand health insurance coverage to the uninsured. The US Department of Health and Human Services awarded a one-year grant to the NC Department of Health and Human Services (NC DHHS) to study policy options to expand coverage to the uninsured ("State Planning Grants"). The grant was used to examine North Carolina data on the uninsured, identify policy options to expand coverage, and develop cost estimates for these policy options. The work was a collaborative effort of four different agencies and organizations: NC DHHS, NC Department of Insurance (NC DOI), the Sheps Center for Health Services Research at The University of North Carolina at Chapel Hill (Sheps Center), and the NC Institute of Medicine (NCIOM). The NC Department of Health and Human Services, through the Office of the Secretary and Office of Research, Demonstrations and Rural Health Development (ORDRHD), provided the overall leadership, direction, and coordination for the State Planning Grant. The State Center for Health Statistics within the NC Department of Health and Human Services collected data in the Behavioral Risk Factor Surveillance Survey (BRFSS), about insurance coverage, access to employer-sponsored insurance, gaps in coverage, and access barriers of North Carolina residents. The Sheps Center analyzed existing data on the uninsured from national data sources and is obtaining data from focus groups of small and large employers, insurance agents /brokers, and the uninsured to find out more about their willingness to pay, the policy options that are most attractive, and the trade-offs that may be reasonable to make health insurance coverage more affordable. The NC Department of Insurance assisted in identifying policy options to reduce health insurance costs and to expand coverage in the private market, and the NC Department of Health and Human Services helped identify public options to expand coverage to the uninsured. Mercer (under contract with the Sheps Center) helped to develop cost-estimates of different cost containment options as well as different models to expand coverage. The NCIOM Task Force on Covering the Uninsured used these data to develop recommendations for ways to expand coverage.