Abstract

Health care reform is an important issue in the 2004 presidential elections and is receiving serious attention from the Democratic and Republican candidates. Changes in the economy that fuelled increased productivity and depressed job growth have also shifted more of the costs of medical care and insurance onto employees. The rising costs of insurance premiums and health care are far outpacing the general inflation rate and workers’ wages. Meanwhile, state governments reacted to widening budget deficits from 2001 to 2003 by reducing Medicaid eligibility and benefits. These changes in employer-based health insurance and government policy have contributed to the largest rise in the share of Americans without health insurance in a decade. In 2002, the uninsured numbered 43.6 million and, according to the Congressional Budget Office, 57 to 59 million non-elderly people are uninsured at some point over the course of a year.