SMCM Prof. Shares Expertise on Health Care for Working Uninsured with Washington

ST. MARY'S CITY, Md. (May 30, 2008) - Todd Eberly, professor of political science at St. Mary's College of Maryland (SMCM), is studying state-based efforts to expand health care to the working uninsured. He has been invited to speak on the often contentious topic at the third annual National Medicaid Congress in Washington, D.C. on June 4.

The meeting of the National Medicaid Congress, from June 4 to 6, will bring together state officials, legislators, and industry representatives to hammer out innovative approaches to health-care reform. Eberly will discuss the recently released study he co-authored on state efforts to expand coverage to the working uninsured-efforts that he says often involve Medicaid.

"Although Medicaid covers 50 million citizens, very few are working adults, as they are typically precluded from program participation. Yet a significant number of the 47 million uninsured are working adults who simply lack access to or cannot afford health insurance," Eberly said. Medicaid is the nation's safety net health-care program for low-income Americans, but the program has historically been limited to children, pregnant women, and the elderly.

In the absence of federal action, many states are undertaking efforts to address the growing number of uninsured. Massachusetts and Montana have had success, though with very different approaches, according to Eberly, while states such as Texas and New Mexico continue to have very high levels of uninsured. "There is tremendous variation across states, which suggests that only a national policy response can effectively deal with the growing problem," he said.

"I find the proposals from presidential candidates to be insufficient in that they all maintain the same flawed system. That said, [Hillary] Clinton appears to have the best grasp of the problem as hers is the only plan that would attain universal coverage, albeit via a politically risky individual mandate," he added.

In a two-part series of reports, Eberly studied approaches to health care reform in seven states to better understand which work best and to help other states design and implement more effective programs. He found that efforts to expand coverage to low-income workers can be challenging for states. Many of the working uninsured are employed by small businesses, often with only 5 or 10 employees. This makes for a diffuse and difficult-to-reach target population, according to Eberly.

In addition, states seeking to expand coverage to the working uninsured need to design a health care program that is affordable while also providing meaningful benefit - a challenge even for the private health insurance market. Eberly found that state efforts can be successful, but difficult. States will face challenges in marketing any program to its target population, and can expect to encounter resistance among small employers hesitant to involve state government in their business practices, according to Eberly. States should also expect to face a significant challenge in designing a meaningful but affordable benefit package, he said.


National Medicaid Congress

To read Eberly's reports:

Marketing State Insurance Coverage Programs: Experiences from Four States
November 2007

Efforts to Expand Coverage to the Uninsured: Program Design Challenges and Tradeoffs in Six States
March 2007

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