The leading advocacy group for health plans recently offered a comprehensive health care reform proposal to achieve universal coverage, reduce the growth of health care costs, and improve the quality of medical care.
The new proposal is the culmination of three years of policy development by America's Health Insurance Plans' board of directors to develop workable solutions to health care challenges.
- Controlling costs. Health plans are urging Congress to set a target of reducing the future growth in health care costs by 30 percent over the next five years. Based on the current projected growth rate of 6.6 percent, this could produce a cumulative savings of more than $500 billion over five years.
- Helping consumers and purchasers. Health plans propose that a new portable health plan be available to individuals and small businesses in all states. This affordable "essential benefits plan" would provide coverage for prevention and wellness as well as acute and chronic care. To maintain affordability, the essential benefits plan would not be subject to varying and conflicting state benefit mandates. The essential benefit plan would also be made available to workers who are going through a job transition or are eligible for COBRA to ensure they are able to maintain health care coverage. The proposal also calls for protecting low-income individuals and working families from medical bankruptcy by making available tax credits to those who spend a set percentage of their income on out-of-pocket health care expenses, including premiums and cost-sharing.
- Achieving universal coverage. Health plans propose guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate. To help working families afford coverage, advanceable and refundable tax credits should be available, phasing out as income approaches 400 percent of the federal poverty line. The plan also calls for shoring up the health care safety net by making eligible for Medicaid every uninsured American living in poverty and strengthening the Children's Health Insurance Program.
- Adding value. Health plans commit to streamlining administrative processes and propose making targeted investments in our public health infrastructure. The plan also calls for refocusing our health care system on keeping people healthy, intervening early, and providing coordinated care for chronic conditions; adopting uniform standards for quality, reporting, and information technology; and investing more in research to better understand which treatments and therapies work best.
