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Health Care Hopes Grow |
| Thu November 16th, 2006 |
Health Care Hopes Grow
Universal Coverage Gains Momentum As Forces Shift
By DIANE LEVICK
Courant Staff Writer
November 16 2006
The prospects for all Americans getting access to health care have brightened after years of gridlock, with recent election results and the insurance industry hopping onboard this week.
But there's still much debate ahead.
The industry's first plan for universal health care, unveiled Monday, was welcomed by consumer advocates as adding momentum to the cause, though they say it doesn't go far enough.
Democrats, meanwhile, have seized power in Congress after many campaigned on the health care issue, raising hopes of consumer groups.
The two developments, some observers predict, could help break the logjam and bring quicker action to address the needs of 46.6 million uninsured Americans, including 407,000 in Connecticut.
"We're seeing a major difference coming from the insurance industry in relation to cooperation in covering the uninsured," said Ron Pollack, executive director of the advocacy group Families USA. "They were obstructionists in terms of expanding health coverage in years past."
He added, "I'm not sure the plan actually achieves universal health care, but it's a major step in the right direction."
The plan from the trade group America's Health Insurance Plans is designed to expand health care access to all children within three years, and to 95 percent of adults within 10 years. The plan includes expanding government-funded programs, establishing new tax credits, and creating new spending accounts with federal incentives.
America's Health Insurance Plans hopes its plan is "a debate-opener," and it intends "to work with stakeholders across the political spectrum," said Karen Ignagni, president and chief executive of the group.
Not all legislators, however, are receptive to the industry's plan.
"I wouldn't trust the industry under any circumstances, except to make a profit for themselves and rake beneficiaries over the coals," said Rep. Pete Stark, D-Calif., a frequent critic of the industry and ranking member of the House Ways and Means Committee's subcommittee on health.
"The insurance industry has always been the problem," Stark said. "I would disregard their plan as being self-serving."
The industry would add millions of customers, boosting revenues and potential profits if universal health care became a reality.
Aetna chief executive Ronald A. Williams defends the industry's plan, saying it has always supported the idea of universal access and that the recommended steps would effectively expand health coverage.
"There's nothing wrong in a mutual beneficial outcome," Williams said.
He, like his predecessor, Dr. John W. Rowe, supports a federal mandate requiring everyone to obtain insurance through purchase or a government program. That idea isn't in the trade group's plan.
The plan calls for expanding the State Children's Health Insurance Program, known as SCHIP, which is funded by federal and state governments. The plan would also extend Medicaid to insure all uninsured adults who earn less than 100 percent of the federal poverty level. Single adults don't currently qualify.
With SCHIP up for reauthorization, Stark believes 2007 could bring the first steps on the federal level toward universal access. SCHIP could be redesigned, he said, to ensure coverage, one way or another, for all children from birth.
More movement toward universal access could come after the 2008 presidential election, in which health care will be a key issue, Stark said. Several states, including Massachusetts, have already passed reforms.
The insurers' national plan would also establish a tax credit of up to $500 for low-income families who buy health insurance for their children, and would create a new, $50 billion "federal performance grant" to help states expand access to insurance.
In addition, the plan calls for "universal health accounts," which would allow anyone to buy any kind of health insurance and pay for medical expenses with pre-tax dollars. There would be federal matching grants for contributions that working families make to their universal accounts.
Insurers also advocate certain steps by states, including premium subsidies to individuals who can't afford insurance, or tax credits to individuals or employers to offset some of the premiums.
The insurers' proposals won't get the nation very far toward a consensus, and the idea for "universal health" spending accounts "falls very short" of what's needed, said Beverly Brakeman, director of Citizens For Economic Opportunity. CEO is a Connecticut coalition of labor and community groups.
The accounts, like the industry's "consumer driven" health plans, shift costs to consumers and don't make insurance more affordable, Brakeman said.
Consumer driven plans feature accounts - often, but not always, funded by employers - that workers use to pay medical bills and help meet a high deductible before insurance kicks in. When an employer-funded account is exhausted, though, workers typically must pay hundreds or thousands of dollars out of pocket for medical bills to reach the deductible.
One thing insurers and their critics agree on is that the lack of health insurance isn't just a problem for the 46.6 million uninsured. The cost of the care they get anyway and can't pay for - at hospitals, for instance - makes its way back into premiums.
"Everyone is paying a premium for uncompensated care," Ignagni said.
What's encouraging about the insurers' decision to offer a plan is that "everybody `gets' that we have a crisis in this country and this state," Brakeman said. "How we're going to fix it is going to get touchy."
On the state level, health care activist Juan A. Figueroa said he's optimistic that legislative leaders such as state Senate President Pro Tem Donald Williams, D-Brooklyn, and Gov. M. Jodi Rell can agree on an action plan for the 2007 session.
Success will depend on how engaged consumers, businesses and others are in the discussion, said Figueroa, who is president of the Universal Health Care Foundation of Connecticut.
Contact Diane Levick at dlevick@courant.com.
Copyright 2006, Hartford Courant
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