“We’ve all learned that changing the health insurance system cannot be accomplished overnight, but it is abundantly clear that it will never be accomplished without an established framework and a clear time table,” said ACP-ASIM President Sara Walker, MD, MACP. “We are asking Congress for a commitment to build on the successes of the American health care system by expanding programs that are already in place and functioning.”
Under the College’s proposal a subsidized health insurance program would be available to all who lack another form of coverage. Health insurance plans would be required to offer a standard basic package of benefits, including preventive services, as a condition of participating in the new subsidy program. Qualified insurance companies would also be required to agree to uniform new federal rules on risk rating and renewability. Coverage would be available to individuals through purchasing group arrangements. These groups would allow individuals access to the steeply discounted rates that insurers currently only offer through large or mid-size employers and provide “one stop” shopping for qualified health plans.
To reach the goal of insurance for all Americans, the College believes that Congress should enact legislation to establish a framework of a step-by-step plan to make affordable coverage available to all Americans. The College’s plan calls on Congress to adopt a resolution establishing the goal of making health insurance coverage available to all citizens within seven years.
“Our plan prioritizes the neediest people for the quickest action,” said Dr. Walker. “Those making less than 200 percent of the federal poverty level would receive relief from the high cost of health insurance beginning in 2005.”
In addition to expanding eligibility and funding for Medicaid and State Children’s Health Insurance Programs (S-CHIPs), the ACP-ASIM proposal calls for a premium subsidy program, starting with individuals with incomes between 100 and 200% of the federal poverty level (FPL). The subsidy program would later be extended to uninsured persons with incomes above 200% of the FPL. The subsidy would be applied toward the purchase of individual coverage to be offered through purchasing group arrangements, toward the employee’s contribution to employer-provided health insurance or toward a “buy in” into the S-CHP program.
The legislation will establish basic benefits requirements and market reforms for health plans as a condition of participation in the premium subsidy program. The basic benefits package would be based on recommendations of an advisory commission to be appointed by Congress. The commission would also report annually on the effectiveness of measures to expand health insurance coverage.
"Even if Congress does not agree to everything we are proposing, we hope to succeed in challenging the conventional wisdom that nothing can or will be done to make health insurance coverage available to everyone before the close of the decade," said Dr. Walker. “We intend to show that it is possible to make coverage available to all within seven years by building upon the current health care system.”
The American College of Physicians-American Society of Internal Medicine is the nation’s largest medical specialty organization and the second largest physician group. Membership encompasses more than 115,000 internal medicine physicians and medical students.