Expand Medicaid Outreach Instead of Creating New Program to Address Uninsured, Columnist States

Instead of creating a new federal program to address the nation's 42.5 million uninsured, "an aggressive outreach campaign to enroll those already eligible for Medicaid" would be the "most effective single effort," Detroit News columnist and retired partner of Mercer Management Consulting John Schnapp states. Schnapp begins his argument by disputing that all of the uninsured can be considered "working families" -- an assumption he states that politicians such as Vice President Al Gore often imply. Only one out of five uninsured individuals fits the working families description of making less than $50,000 per year, Schnapp notes. Instead, the largest group of uninsured -- 13 million -- are those with incomes of at least $50,000. Nearly half that group earns more than $75,000 per year. Why those individuals, "who can surely afford insurance," lack coverage "is a mystery," Schnapp states, pointing out that the latest Census Bureau statistics also fail to address that question. The next largest group of the uninsured -- 10.4 million -- are the "truly poor," those in households "primarily headed by adults who did not work even part-time during the previous year." Schnapp adds that "[m]ost" of those individuals "surely qualify" for Medicaid, but are not enrolled, "perhaps because of Medicaid's red tape and bureaucracy." The third largest group of the uninsured are young people ages 18-24, "a group made up primarily of college students or single adults just beginning their vocational careers." About one-fifth of people in this age group, or 5.5 million, lack insurance. Another five million of the uninsured are undocumented immigrants, and 1.4 million more uninsured are "non-poor legal immigrants who are not citizens," and who are "unfamilia[r] with the concept" of insurance. Schnapp surmises that the numbers indicate "that while lack of health coverage may be a social problem, it is not the social crisis that inflated political rhetoric has characterized." He concludes by advocating an outreach campaign to enroll families already eligible for Medicaid and suggesting that states "more appropriately" finance Medicaid to "liberalize" eligibility (Schnapp, Boston Globe, 10/29).