Details Missing on Coalition Plan for Calif. Uninsured

Published April 1, 2007

In January, a group of the nation’s top health care organizations forged a coalition, the Health Coverage Coalition for the Uninsured (HCCU), proposing a plan to provide insurance coverage to all Americans, starting with California.

But unlike Gov. Arnold Schwarzenegger’s (R) proposed plan to accomplish that task, the coalition would use incentives, not mandates.

“The coalition is focused on California,” explained Kathleen McKenna, California director of public policy communications for Kaiser Permanente, a nonprofit health maintenance organization. “Within California, there continue to be numerous meetings aimed at reaching an agreement on the details of the campaign to insure all residents.”

The coalition is composed of 16 groups, including major health market players such as the American Association of Retired Persons, American Medical Association, Blue Cross and Blue Shield Association, Johnson & Johnson, Pfizer, Inc., United Health Foundation, and U.S. Chamber of Commerce.

Two Approaches

According to the HCCU Web site, the group aims to achieve universal coverage on a national level in two phases.

The first calls for a tax break for people earning up to three times the federal poverty level who buy private insurance plans that cover children, and asking Congress to increase State Children’s Health Insurance Program (SCHIP) funds and to grant local governments more power to formulate expanded health coverage programs.

Under the plan, SCHIP’s funding increase would amount to $45 billion in the first five years.

The second phase would expand the terms of adult eligibility for Medicaid by removing family status as a requirement, basing coverage qualifications solely on financial need.

Private insurance plans also would expand under the proposal–specifically, the proposal recommends a tax credit for those who purchase insurance for adults and earn up to three times the federal poverty level. The plan is for the tax credit to cover a significant amount of the insurance premium, though the amount has not been specified.

Wrong Goal?

Not everyone is convinced the HCCU’s proposal is feasible.

“It remains to be seen if they can put forward any particularly detailed proposal,” said Michael Tanner, director of health and welfare studies at the Cato Institute, a libertarian think tank in Washington, DC.

“They are in favor of apple pie and motherhood,” Tanner continued. “But aren’t we all? I have not seen an actual concrete proposal that they all agree upon. I think there is little chance of anything substantial passing in Congress as a result of this.”

McKenna said the coalition expects to influence health care reform legislation that will pass in California by the end of the year.

“We don’t agree on everything, but there are key issues that we all believe are important,” McKenna explained. “We want to help move the issues forward and not let them peter out. The three basic principles all the stakeholders agree upon are the need for universal health care coverage, a response by the health community that is all-inclusive, and a need for a broad-based funding source that includes the medical community, government, employers, and individuals.”

Hot Topic

Democratic presidential candidates Sens. Hillary Rodham Clinton (NY), John Edwards (NC), and Barack Obama (IL) have all said it is important to implement universal health insurance coverage during the next administration. McKenna said the lack of coverage is one of the most damaging elements of the nation’s health care system.

“In California alone we have approximately six million uninsured people,” McKenna said. “That’s a staggering number, and we know that many of them are not receiving regular care. Instead they are going to our emergency rooms.

“If we can provide insurance to all, health care and quality of life would improve,” McKenna continued. “Costs would go down because [people] would have access to and take part in preventative care, which is less expensive than catastrophic and emergency room care.”

But Tanner said that’s not the solution to the nation’s health care problems.

“Simply putting a paper in everyone’s hand and saying they now have insurance won’t do anything,” Tanner noted. “People need access to health care, not coverage. Across the world people have insurance, but they don’t have the health care.

“Insurance and health care are not synonymous,” Tanner continued. “We need to lower the cost of health care and insurance so people can take part in, and not damage, the best health care system in the world.”

Aricka Flowers ([email protected]) writes from Chicago.