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Overburdened and Overwhelmed: The Struggles of Communities with High Medical Cost Burdens

Research Report
November 2007
Peter J. Cunningham

The number of people with high medical cost burdens varies widely across the nation, reflecting differences in the number of both uninsured and underinsured people. Those states with the largest numbers of individuals with high medical expense face numerous difficulties in achieving affordable coverage, and lack of action at the federal level has driven many to undertake their own heath care reform efforts. Reliance on state efforts alone, however, is unlikely to lead to major national expansions in coverage and will not alleviate persistently high degrees of medical cost variation across the country.

This article is available at The Commonwealth Fund’s Web site.




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The Center for Studying Health System Change Ceased operation on Dec. 31, 2013.