Countering a trend of increased political acrimony and partisanship, three leading organizations with divergent points of view in the health policy arena - the Health Insurance Association of America (HIAA), Families USA, and the American Hospital Association (AHA) - have joined forces to expand health coverage for a substantial portion of America's 43 million uninsured.
"As organizations representing the breadth of the health care community, we stand together to forge common ground to end the gridlock over extending health care coverage to the uninsured millions living in America today," according to a statement by the three organizations.
Families USA, the national organization for health care consumers, and HIAA, the national trade association representing almost 300 insurance companies and health plans, battled over health care reform in 1993-1994 and continue to fight over the issue of a patients' bill of rights. Yet over the last several months, the two rivals set aside their differences and negotiated a three-part proposal to significantly expand health insurance coverage. They have been joined by the AHA, a not-for-profit association of health care providers and individuals committed to health improvement of their communities.
The organizations are calling for "common ground and coalesced action as the debate on the uninsured begins," according to the statement. "Political gridlock should no longer be an option in dealing with America's un-insurance epidemic," said Ron Pollack, Executive Director of Families USA. "We must transcend partisan, ideological, and interest-group boundaries to find common ground so we can move towards health coverage for everyone."
"In the past, every group interested in extending coverage to the uninsured held out for their favorite approach, and their second choice always was the status quo," observed HIAA President Chip Kahn. "As a result, nothing was accomplished. By coming together now, HIAA, Families USA, and the AHA are saying we can get started if we seek common ground."
"People often say that no one in Washington can agree. Today, we're happy to prove them wrong," said Rick Pollack, AHA's executive vice president. "With this step, we've laid a strong foundation we hope to build upon to improve access and coverage for all."
The proposal focuses on low-wage workers and their families. Of the 43 million uninsured Americans, slightly more than half (23 million) have annual incomes below 200 percent of the federal poverty level. It contains the following elements:
· Medicaid would be expanded for all people under 65 years of age with annual incomes below 133 percent of the federal poverty level ($18,820 for a family of three). Eligibility would be based strictly on income and would apply equally to parents, children, and childless adults. This expansion would be subsidized with enhanced federal matching funds well in excess of the current Medicaid funding formula.
· As is currently done for children, states would be given the option to provide coverage for parents and childless adults with incomes between 133 and 200 percent of the federal poverty level ($28,300 for a family of three) through Medicaid or a program like the State Children's Health Insurance Program (S-CHIP). This expansion also would be subsidized with enhanced federal matching funds. Both the Medicaid and S-CHIP expansions would be developed to ensure optimal enrollment of people newly eligible for coverage.
· A non-refundable tax credit would be created to help low-income workers who turn down employer-sponsored coverage because they can't afford their share of the premium. This credit would be available to employers to help them defray the out-of-pocket premium costs of employees with incomes between 133 and 200 percent of the federal poverty level. For example, if a business currently pays 70 percent of the premiums for all workers in the company, it would receive a tax credit to pay all or part of the remaining premium for its low-income workers.
The three groups are working together to promote the proposal among interest groups and policymakers, and will reach out to the eventual President-Elect, the new Congress, and key stakeholder organizations to achieve bipartisan cooperation resulting in the enactment of expanded health coverage next year. They also acknowledge that their proposal would require a significant public investment.
"But - with the economy in good condition, the federal budget in surplus, and state budgets in good shape as well - there never has been a better time to make such an investment," their statement concludes.
