Researchers at the Commonwealth Fund say either expanding Medicare or having consumers buy private health coverage through state insurance exchanges could be an efficient way to reduce the number of uninsured Americans.

The researchers have reached that conclusion in analysis of the AmeriCare health finance reform proposal introduced by Rep. Pete Stark, C-Calif., and the Healthy Americans Act, introduced by Sen. Ron Wyden, D-Ore.

Stark’s bill would open Medicare to all individuals.

The Wyden bill would shift all group health plan members into the individual health insurance market, then require individuals to buy private health coverage through “state health help agencies” or through other means.

If enacted, the Stark proposal would cost the federal government $154 billion in 2007 but would provide health coverage for most uninsured Americans and reduce overall health spending by $61 billion because of savings on insurance administration and prescription drugs, according to the researchers at the Commonwealth Fund, New York.

The Wyden proposal would provide health coverage for most uninsured Americans, increase federal spending by about $24 billion in 2007, and reduce overall health spending by $4.5 billion, researchers estimate.

Most of the savings would come from reductions in insurance administration costs, researchers say.

President Bush’s plan to replace the current group health tax exclusion with a deduction for anyone with health coverage would cost the federal government about $70 billion, reduce health system spending about $12 billion, and provide health coverage for only about 20% of the uninsured, researchers estimate.

The Bush proposal would provide far more tax savings for families with annual incomes of $150,000 per year than for families with incomes of less than $10,000, the researchers say.