How to bring down the costs of the country's $2.4 trillion healthcare system and make care affordable for all Americans dominated the discussion Tuesday as the Senate Finance Committee convened for a hearing on how best to fix a broken system.
The committee, chaired by Sen. Max Baucus (D-Mont.), held the second of three roundtables to discuss healthcare reform. The first held two weeks ago focused on system delivery reform. The one Tuesday tackled providing healthcare coverage for all Americans. The roundtable slated for next week will take up how to finance reform.
"We have a chance to make sure that all Americans have a fair chance at good health," Baucus said in his opening remarks on Tuesday. "To make sure that no family goes bankrupt due to medical costs, and to make sure that the insured no longer have to pay the cost for the uninsured."
"The cost of inaction is too high," Baucus added. "It's too high for individuals, families, businesses, and state and federal governments.
John Castellani, president of the Business Roundtable, which represents some of the nation's top business and corporate executives, told the committee, "We must build upon our employer-based system." He noted that 177 million Americans get their health insurance coverage through their employers.
"Today, all employers make difficult economic decisions about whether to offer health insurance and face enormous increases year after year," he said. More than 98 percent of employers with 200 or more employees offer health insurance today, he noted. "But the cost pressures are tremendous," he said.
Castellani urged the committee to support reform that "reinforces the existing employer-based system."
"The federal ERISA (Employee Retirement Income Security Act) statute that governs these plans gives employers the flexibility to design and finance plans that meet the employees' needs - a system that has proven successful in making coverage widely available to workers. Tampering with this law at this time could cause massive dislocations for those 132 million Americans who have private workplace coverage."
Castellani said the Business Roundtable is concerned about public plan proposals that would compete in the private marketplace.
"We do support national rules to create a more competitive and affordable marketplace for individuals and small businesses," he said.
Karen Ignagni, president of America's Health Insurance Plans (AHIP), the leading health insurance industry organization, told the committee the industry was on board with reform and announced that AHIP was ready to recommend an end to charging women more for health insurance.
"You do rate gender, and women are charged higher premiums than men for the same coverage," said Sen. John Kerry (D-Mass.). "It seems to me that's insurance discrimination."
We don't believe gender should be a subject of rating," Ignagni said, adding that AHIP is recommending the practice be discontinued in the individual market provided all Americans are required to have insurance coverage. "So, we agree with you," she said.
AHIP's position was the most recent in insurance industry concessions. Last year insurers said they would end the practice of denying coverage to people with pre-existing conditions. Earlier this year, they said they would stop charging them more for coverage.