Judith Feder, one of the nation's foremost experts on the U.S. health insurance system, discussed the Affordable Care Act and Medicare on April 14 at the Ronald Tutor Campus Center as part of the 2011 USC Schaeffer Center seminar series.

Feder is currently a professor at Georgetown Public Policy Institute, where she served as dean from 1999 to 2008. She previously served in former President Bill Clinton's administration as the staff director of the U.S. Bipartisan Commission on Comprehensive Health Care and the principal deputy assistant secretary of the U.S. Department of Health and Human Services.

Drawing on her political experience and health policy expertise, Feder provided an overview of the 2010 health reform law and described the challenges facing those who remain uninsured.

She stated that the majority of uninsured individuals in the United States are employees who do not receive insurance from their employers.

"When you look at the uninsured, they're disproportionately low and modest wage workers," Feder said.

These uninsured low-wage workers struggle to find affordable private plan insurance outside of the employer-based health insurance market where they are often asked to pay higher premiums or may be denied coverage entirely, Feder remarked.

"It is not a safety net of any kind," Feder said. "Low and modest wage workers are not getting coverage through their job and not getting Medicaid."

Medicaid is the federal-state joint health insurance program for individuals and families with low incomes. Feder noted that many uninsured low-wage workers are ineligible for the means-tested government program because their incomes are still too high or they do not meet other requirements for financial assistance.

Feder said the Affordable Care Act would allow more individuals to be covered under Medicaid by relaxing eligibility criteria as well as expanding Medicare benefits for older adults.

In her discussion about Medicare, she raised concerns about the recent House Budget Committee proposal to transform the program. Medicare is the federal health insurance program that provides coverage to people who are aged 65 and over.

Under the proposal, beginning in 2022, all newly eligible Medicare beneficiaries will only be able to access health coverage through private insurance plans. In essence, Medicare would no longer provide coverage but instead offer a subsidy for the purchase of private insurance.
Feder said that private insurance plans would cost significantly more than traditional Medicare.

Throughout her talk, she acknowledged the continued public skepticism about the Affordable Care Act and efforts to repeal it, but emphasized that reform was necessary to address the chronic ills afflicting a system that inextricably impacts the lives of all Americans.

"We're all buying in the same health care system," Feder said. "We're all in this together."

The event was sponsored by the Leonard D. Schaeffer Center for Health Policy and Economics at USC; the USC Edward R. Roybal Institute on Aging; the USC School of Policy, Planning, and Development; the Titus Family Department of Clinical Pharmacy and Pharmaceutical Economics and Policy; and the USC School of Pharmacy.