Impact of Various Health System Reform Options on the Distribution of Health Care Costs Across All Payers

Developing a better (and more timely) tool for assessing the impact of proposed changes in health care financing on all segments of the population was the goal of this Urban Institute study. The project built upon the Institute's TRIM2 model, which simulates the effects of tax and government programs on family income, by adding the ability to simulate the expenses of private health insurance and out-of-pocket expenses. In addition, cost shifting among public and private payers, including the burden of uncompensated hospital care, was simulated. The expanded TRIM2 model was then used to analyze how costs are redistributed among payers and the impact on the number of uninsured and underinsured associated with several different strategies to restructure health care financing.