AHIP Now Lobbying For Universal Medical Insurance

The AHIP is part of two major factions, the business lobby and health insurance industry, that are discussing extensive changes that would ideally help cover the nation’s 47 million uninsured, improve care, and stall the growth of healthcare spending. This new attitude contrasts with the one that prevailed in 1993 and 1994, when the insurance industry sponsored incredibly effective ads featuring a middle-class couple named Harry and Louise fussing about how President Clinton’s medical insurance plan would limit their health choices - “They choose,” Harry said. “We lose,” Louise agreed - and business lobbies funded an unprecedented campaign against the Clinton health insurance plan. It appears many of the business groups are more comfortable with the medical insurance reform process this time. In 1993-1994 the plan happened though a secretive closed door process. But it appears next year’s legislation will happen in Congress, where these groups are comfortable operating. The president of AHIP, which insurers that cover about 200 million Americans, said their organization began working on medical insurance reform strategies two full years ago. Last month, AHIP said it supported new regulations that prohibited insurance companies from denying medical coverage to people with preexisting conditions as long as individuals were required to buy medical insurance. AHIP thinks that if insurers are required to accept everyone who applies, then each person should be mandated to buy medical insurance. Obama has opposed requiring individuals to buy medical insurance thus far. The new AHIP proposal outlines strategies to achieve four main objectives to improve medical insurance: controlling costs; helping consumers and purchasers; achieving universal medical insurance coverage; and adding value. Controlling costs: A financially sustainable and affordable health care system can only be achieved by bringing underlying medical costs under control. If health care costs are allowed to continue rising at rates far exceeding economic growth, they will thwart all efforts to improve coverage and care. Health plans are urging Congress to set a bold target of reducing the future growth in health care costs by 30 percent over the next five years. Based on the current projected growth rate of 6.6 percent, this could produce a cumulative savings of more than $500 billion over five years. To achieve these goals, health plans are proposing that a public-private advisory group be created to provide specific policy recommendations to Congress on reducing health care costs. This new advisory group would include input from a wide variety of stakeholders to provide objective, independent recommendations. Helping consumers and purchasers: Insurance market rules need to be reformed to help individuals and small businesses access affordable coverage while avoiding duplication of administrative and regulatory responsibilities. These reforms must be coupled with initiatives to provide one-stop access to coverage options and clear, consistent information on quality and cost of care. Health plans propose that a new portable health plan be available to individuals and small businesses in all states. This affordable “essential benefits plan” would provide coverage for prevention and wellness as well as acute and chronic care. To maintain affordability, the essential benefits plan would not be subject to varying and conflicting state benefit mandates. The essential benefit plan would also be made available to workers who are going through a job transition or are eligible for COBRA to ensure they are able to maintain health care coverage. The proposal also calls for protecting low-income individuals and working families from medical bankruptcy by making available tax credits to those who spend a set percentage of their income on out-of-pocket health care expenses, including premiums and cost-sharing. Achieving universal coverage: By addressing rising costs, reforming insurance market rules, and enhancing value in care delivery, the nation can provide all Americans – those with and without coverage today – affordable coverage they can keep. Health plans propose guaranteed coverage for people with pre-existing medical conditions in conjunction with an enforceable individual coverage mandate. To help working families afford coverage, advance able and refundable tax credits should be available, phasing out as income approaches 400 percent of the federal poverty line. The plan also calls for shoring up the health care safety net by making eligible for Medicaid every uninsured American living in poverty and strengthening the Children’s Health Insurance Program. Adding value: The nation must create a 21st century system where quality and effectiveness are rewarded, administrative efficiency is achieved, and primary care and wellness are encouraged.