NEW YORK - Commonwealth Fund researchers have created a plan that would insure 44 million of the estimated 48 million uninsured Americans in 2008 and save approximately $1.6 trillion over the next 10 years.
In a recent article published in Health Affairs, researchers say the plan would offer new health insurance choices to individuals and small businesses for 30 percent less than what employers currently pay.
The plan is expected to cause minimal disruption for people satisfied with their current coverage, researchers said, and any decisions to switch to the new coverage would be voluntary.
Reports indicate financial savings would only be possible if coupled with efforts to reform how the United States pays for healthcare, investment in better information systems and the adoption of initiatives to improve public health.
"This approach builds on group insurance coverage and the national reach of Medicare and at the same time addresses the high administrative and premium costs for individuals and small groups," said Commonwealth Fund President Karen Davis, who co-authored the article. "It also demonstrates that it is possible to buy more for our healthcare dollars, cover all Americans with high quality insurance and institute real reforms to stem rising healthcare costs, saving $1.6 trillion over 10 years."
The "Building Blocks" plan would preserve employer-sponsored health insurance, Medicaid and the State Children's Health Insurance Program (SCHIP), according to researchers. It would build on the existing success of the Medicare program by offering a Medicare-like option along with the choice of private health plans through a new national health insurance "connector."
The approach calls for:
- A national "connector" that would offer individuals and small businesses a choice of private plans or a Medicare Extra plan.
- The requirement that all applicants be given health insurance at standardized rates regardless of their health status.
- Tax credits to make sure premiums are affordable. Premium assistance would be available to ensure that premiums do not exceed 5 percent of income and 10 percent of income for higher-income tax filers.
- The expansion of Medicaid and SCHIP to cover all low-income adults and children below 150 percent of the federal poverty level with modest copayments for health care services and no premiums.
- The requirement that everyone enroll in a health insurance plan - including uninsured individuals who file taxes, who would be automatically enrolled.
- The requirement that employers either provide health insurance or pay 7 percent of payroll (up to $1.25 an hour) into a pool to help finance coverage.
- Reforms that would extend Medicare extra benefits to current Medicare beneficiaries, eliminate the two-year waiting period for Medicare for the disabled and allow adults age 60 or older to buy in to Medicare.
Analysts from The Lewin Group say the number of uninsured in the United States would drop to less than 4 million in the first year that the plan is implemented.
An estimated 60 million people would get health insurance through the new national connector – a majority of them as a result of small businesses deciding to buy into the connector and its plan choices. About 14 million would be previously uninsured people and an additional 1.2 million would be individually insured people who switch to the connector.