WASHINGTON – A diverse coalition of advocacy groups, employers, payers and healthcare associations preceded President Bush’s plan for universal coverage by announcing on Jan. 18 an “unprecedented” and “historic” proposal to provide health coverage to the nation’s 47 million uninsured citizens.
But the coalition, like the president in his State of the Union Address, failed to explain how such a program would be funded.
Supporters say the first part of the two-phase plan would cost about $45 billion over five years and cover the 9 million uninsured children living in the United States. They offered no cost estimate for the second phase, which would extend coverage to the 38 million adults without insurance. They did say Congress’ pay-as-you-go policy would play a role in determining funding.
The Health Coverage Coalition for the Uninsured, which has met 15 times in the past two years, is made up of 16 organizations, including America’s Health Insurance Plans, the American Medical Association, the American Hospital Association, Families USA, Kaiser Permanente and the UnitedHealth Group.
Reed Tuckson, MD, senior vice president of Consumer Health and Medical Care Advancement for UnitedHealth, said the consequences of being uninsured are “significant for those who are uninsured, and unacceptable for those who are insured.”
“Today we release an unprecedented – indeed an historic – agreement,” said Ron Pollack, founding executive director of Families USA. He said HCCU has moved beyond individual principles and “mere speechifying” to a set of recommendations for covering the uninsured. HCCU is looking to Congress to make bipartisan efforts to enact these recommendations.
Referring to the ideological and political divergence of many of the coalition’s groups, Pollack said the HCCU plan is designed to transcend ideology and partisanship. “Throughout this process, we challenged ourselves to reach consensus. We now challenge America’s policymakers to work together to expand health coverage for the uninsured, starting with America’s children,” he said.
The coalition’s plan is balanced to include public and private healthcare solutions for children and adults.
Two-thirds of children eligible for public coverage, in programs such as Children’s Health Insurance Plans and Medicaid, are not enrolled, Pollack noted. HCCU’s solution is a “one-stop shopping” system, in which children participating in other means-tested programs (such as free and reduced-price school lunches and food stamps) would become automatically enrolled in Medicaid or CHIP. This program would rely on federal funding for states to underwrite all of the costs.
For private coverage, children and adults who lack insurance but have family incomes of up to 300 percent of the poverty level would receive tax benefits on a sliding-scale basis to make employer-sponsored health plans affordable.
Phase two of the plan involves authorizing states to expand Medicaid coverage to all low-income adults up to the federal poverty level.
If the public and private children’s plan is enacted, Pollack said, up to 98 percent of children could have coverage within a few years.