A diverse coalition of advocacy groups, employers, payers, and healthcare associations has put forward what it hailed as an "unprecedented" and "historic" plan to provide health coverage to the nation's 47 million uninsured citizens on Jan. 18. The only thing missing from the otherwise detailed presentation - a price tag.
Supporters say the first phase 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. But they offered no estimate for the cost of the second phase, which would extend coverage to the 38 million American adults without insurance. Presenters did say Congress' pay-as-you-go (PAYGO) policy will play a role in determining funding.
The Health Coverage Coalition for the Uninsured (HCCU), which 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 UnitedHealth Group.
Reed Tuckson, MD, senior vice president of Consumer Health and Medical Care Advancement for UnitedHealth and one of the presenters of the plan, 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 policy makers to work together to expand health coverage for the uninsured, starting with America's children," he said.
The coalition's two-phase plan is balanced to include both public and private healthcare solutions for children and adults.
Two-thirds of children eligible for public coverage such as Children's Health Insurance Plans (CHIP) 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 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 combined public and private children's plan is enacted, Pollack said, up to 98 percent of children could have coverage within a few years.
HCCU members repeatedly stressed the importance of bipartisan efforts in Congress. "We have had very positive discussions with members of Congress." said Karen Ignani, president of AHIP. "On this issue, the polls show that Democrats, Republicans and Independents want progress."