MHA's Executive Briefing

Bill would expand access to primary and preventive care

American Hospital Association-backed legislation introduced recently would provide $75 million in grants to help integrated health systems expand access to primary and preventive services for the medically underserved. Sponsored by Reps. Michael Burgess, M.D. (R-TX) and Rep. Bart Stupak (D-MI), the Patients and Public Health Partnership Act (H.R. 5544) would provide the funding through a three-year demonstration project.

“With nearly 47 million uninsured Americans and more than 56 million Americans lacking access to primary and preventive care, it is clear that Congress needs to explore additional ways to make cost-effective primary care much more available and accessible,” AHA said in a recent letter of support to the bill’s sponsors.

Bill would fund state pilot programs to expand health coverage

Legislation announced April 25 by Sens. Russ Feingold (D-WI) and Lindsey Graham (R-SC) would fund state pilot programs to expand health coverage at an estimated cost of up to $40 billion over 10 years. The senators said the State-Based Health Care Reform Act (S. 1169) would overcome the national stalemate over health care coverage by having states experiment with different solutions during five-year pilot programs.

States could use a variety of methods to expand health care coverage, from health savings accounts to single-payer systems, and would have to meet fewer requirements. “By helping states try different approaches, we can figure out the best way to ensure all Americans receive the health care they need,” the senators said.

States would apply for grants through a Health Care Coverage Task Force, which would select projects, oversee implementation and review progress.

[ via AHA News Now ]

Stark files universal coverage measure

Rep. Pete Stark (D-CA has taken a stance on the universal health coverage issue. Stark, who serves as chairman of the House Ways and Means Health Subcommittee, has introduced a bill creating a universal health plan.

Under the AmeriCare Health Care Act, all U.S. citizens would be covered either through their employer or Medicare-like government insurance. To extend this coverage, AmeriCare would use Medicare's administrative functions, but would add a a prescription drug benefit, mental health parity, pediatric care, family planning and pregnancy services.

The measure would limit out-of-pocket costs, and subsidize costs for people with incomes of less than 300 percent of the federal poverty level. The AmeriCare program would cost $154.5 billion, but would save households, states and local governments more than that, resulting in a net $60.7 billion reduction in overall spending, according to estimates by the Commonwealth Fund.

To learn more about Stark's proposal, read this United Press International piece and read Rep. Stark's press release on the subject.

[ via Fierce Healthcare ]

Bipartisan health coverage bills introduced in Congress

Sens. Jeff Bingaman (D-NM) and George Voinovich (R-OH) and Reps. Tammy Baldwin (D-WI), Tom Price (R-GA) and John Tierney (D-MA) on Jan. 17 introduced bipartisan legislation that would allow states to experiment with various efforts to reduce the number of uninsured through a federal-state partnership. Congress would authorize grants to states to carry out a broad range of strategies to increase health care coverage, from tax credits and health savings accounts to expansions of Medicaid or the State Children’s Health Insurance Program.

A bipartisan State Health Innovation Commission would review the proposals and submit to Congress a slate of recommended state applications. “Extending health care to the millions of Americans who are uninsured will require the innovation of governors and other leaders in all 50 states,” Bingaman said. “Our legislation simply helps each state implement the solution that is right for them.”

[ via AHA News Now ]

House bill aims to foster state plans for uninsured

Bipartisan legislation introduced in the House would give states greater flexibility and some federal backing to develop programs to cover uninsured residents. The bill was introduced by Rep. Tom Price (R-Ga.) and three co-sponsors.

A spokesman for Price said the bill was referred to the Energy and Commerce Committee, which could consider the legislation in September after it returns from recess.

Lawmakers have shown renewed interest in health care reform in recent weeks. In July, Rep. Pete Stark (D-Calif.) introduced legislation to offer the uninsured subsidized health insurance through a new government program modeled on Medicare. Sen. Russ Feingold (D-Wis.), meanwhile, introduced a bill that like Price's would focus on state-based efforts.

[ via Modern Healthcare ]

Healthcare reform proposals re-emerge in Congress

Rep. Pete Stark (D-Calif.) plans to introduce legislation that would create a new government program modeled on Medicare as a means to achieve universal healthcare. Stark has scheduled a news conference today to discuss the bill. In a brief statement, his office said the bill would build on "what works in our current healthcare system." People would receive coverage either through an employer or the new program, AmeriCare.

Separately, Sen. Russ Feingold (D-Wis.) plans to introduce a bill that would finance universal healthcare pilot programs in a few states, giving states flexibility to craft different approaches after meeting certain minimum standards. Feingold's office said the program's $32 billion, 10-year cost would be paid for through spending offsets. A Health Care Reform Task Force under HHS would select and oversee the state projects, each of which would last a minimum of five years. At the end of the five years, the task force would make healthcare reform recommendations to Congress based on the experience of the pilot programs. Companion legislation has not been drafted for the House. Read more about the bill on Feingold's Web site.

[ via Modern Healthcare ]

Insured But Not Protected: How Many Adults Are Underinsured?

Health insurance is in the midst of a design shift toward greater financial risk for patients. Where medical cost exposure is high relative to income, the shift will increase the numbers of underinsured people. This HealthAffairs study estimates that nearly 16 million people ages 19–64 were underinsured in 2003. Underinsured adults were more likely to forgo needed care than those with more adequate coverage and had rates of financial stress similar to those of the uninsured. Including adults uninsured during the year, 35 percent (61 million) were under- or uninsured. These findings highlight the need for policy attention to insurance design that considers the adequacy of coverage.

Covering Kids Act introduced

The Covering Kids Act of 2005 was introduced on May 17 by Senate Majority Leader Bill Frist, R-TN, and Sen. Jeff Bingaman, D-NM. The legislation would provide $100 million in grants to organizations that conduct innovative programs to enroll eligible children in Medicaid and the State Children's Health Insurance Program and give states more flexibility to streamline their Medicaid and SCHIP enrollment processes. 

Currently, there are nearly 10 million children in the United States without health insurance coverage. Over half of these children live in families with incomes below 200 percent of the federal poverty level and are eligible for coverage under either the State Children’s Health Insurance Program (S-CHIP) or Medicaid, but are not enrolled in those safety net programs. Studies have shown that the families of many eligible children are not familiar with the availability of safety net coverage or face other barriers that prevent enrollment.

Congress seeks solutions for the uninsured

Lawmakers from both parties want to expand health coverage, just in very different ways.

House Democrats lay out plan to help uninsured

House Democrats introduced three bills aimed at cutting America's number of uninsured by half. One would let insurers band together to sell insurance to self-employed individuals and small businesses and would create a 50% tax credit to help fund insurance purchases. A second bill would expand healthcare coverage to up to 7.5 million uninsured low-income parents through Medicaid programs and the State Children's Health Insurance Program. The third bill would allow uninsured people over age 54 to purchase Medicare coverage and receive tax credits for 75% of the cost; nearly 4 million people would be eligible. Democrats said the three proposals combined could expand healthcare coverage to up to half of America's estimated 45 million uninsured. A price tag for the bills was not available.