A health-plan trade group on Tuesday unveiled a plan it believes will reduce health-care costs, allow for universal coverage and improve quality of care -- but only a few specifics were offered and the plan came under fire as being too self-serving to insurers.
America’s Health Insurance Plans, which represents health insurers and health plans that cover millions of Americans, said it believes it has ways to deal with four of the thorniest issues in the health system.
First, in the matter of cost controls, AHIP asked Congress to try to reduce the growth of health-care costs by 30% over the next five years, saying that could save $500 billion.
As befits one of the thorniest issues in health care, AHIP’s recommendation was just a call for further study, “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,” the press release said.
In addition, AHIP called for improved efficiency and an emphasis on preventive care, saying that “Health plans commit to streamlining administrative processes and propose making targeted investments in our public health infrastructure.” The release provided no more specifics on how this would be done.
An AHIP spokesman said few details were given because the group is “in the process of working on some things” in that area.
“We are working with the provider community to streamline the interaction between providers and health plans. We want to simply that process by developing an online portal,” he said.
AHIP did provide some more detailed proposals in other parts of the plan.
On the issue of helping consumers and purchasers of health care, AHIP proposed the creation of a portable health plan that would be available to individuals and businesses in all states, including for people going through job transitions. Health insurance is regulated at the state level, which means it’s tough to find exactly the same type of plan in different states.
AHIP said this “essential benefits plan” would cover preventive care as well as regular medical coverage, and that “To maintain affordability, the essential benefits plan would not be subject to varying and conflicting state benefit mandates.” States often impose mandates to cover certain procedures or conditions, a practice which has long been decried by the insurance industry.
It also proposed ways to bring about universal health coverage, including making every impoverished adult American eligible for Medicaid, and strengthening the Children’s Health Insurance Program. It said that coverage should be offered to people with pre-existing conditions and that there should be “an enforceable individual-coverage mandate.” One difficulty of that proposal is that it calls for more government spending at a time when the state and federal governments are trying to cut back.
In addition, AHIP suggested that tax breaks might be able to help alleviate some of the cost burdens of health care. For instance, it called for tax breaks for people who spend a certain portion of their income on out-of-pocket health-care expenses in order to help stave off bankruptcy.
It also suggested that tax credits be made available to working families, in order to allow people to afford coverage, that would phase out as the household approaches 400% of the U.S. poverty line.
Health-care policy moves that offer tax breaks often haven’t met with much success because lower-income people don’t pay that much in taxes to begin with, so the benefit of a tax break doesn’t seem as tempting to them, compared with the cost of the actual product.
However, the AHIP spokesman said that because the proposal called for refundable tax credits, so that even if people don’t pay taxes they could get the credits, it would work better than a conventional tax break.
The announcement drew praise as a step forward from none other than Sen. Ted Kennedy (D-Mass.), who has been at the forefront of efforts to shore up the nation's health-care system over the years.
"There's a spirit of optimism about our work to ensure quality, affordable health care for all Americans, and today's announcement adds to that optimism. The insurance industry has advanced serious proposals that deserve serious analysis and consideration," Kennedy spokesman Anthony Coley said, as reported by the Associated Press.
Still, the proposals drew objections from some health-care reform advocates.
"AHIP’s plan still lets insurers charge higher premiums for older and sicker people and for women," said Richard Kirsch, national campaign manager at Health Care for America Now, in a statement. "Their proposal pushes high-deductible plans and still lets insurance companies decide whether or not to approve the care your doctor says you need."
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