• Health reform
• EMRs
• Medicare
• Liability
• AMA House
• » More

• Contract Language
• Ethics Forum
• In the Courts
• Practice Management
• Technically Speaking
• » More

• Issue dates
• Regions
• Health plans
• Sections
• News briefs
• Columns
• Editorials
• Letters
• Series
• Writers
• Other years

• Search tips
• Email alert
• RSS
• Mobile
• Subscribe
• Institutions
• Staff directory
• Advertising
• Permissions
• Reprints
• News media
• Site guide
• Useful links
• About
• Premium
• Contact

• AMA Wire
• CPT
• DMPHP
• JAMA
• JAMA Network
• news@JAMA
• Virtual Mentor
• Physician jobs

Doctor-backed bill seeks to help uninsured

A senator proposes a plan that would expand Medicaid, provide low-income tax credits and create statewide purchasing pools.

By Joel B. Finkelstein, amednews staff. May 26, 2003.

• PRINT|
• E-MAIL|
• RESPOND|
• REPRINTS|
• SHARE
•  

Washington -- A comprehensive bill to help uninsured Americans get health coverage combines popular proposals and builds on existing programs, say the bill's proponents.

The Health Coverage, Affordability, Responsibility and Equity Act was introduced May 8 by Sen. Jeff Bingaman (D, N.M.). It incorporates principles and language laid out by the American College of Physicians in a proposal to have all Americans covered within seven years.

"By emphasizing incentives, consumer choice, help to small businesses and markets, the Bingaman proposal differs in philosophy and approach from ... other proposals that relied principally on mandates to bring about change," according to a statement from the college.

The bill, also known as the HealthCARE Act, is supported by physician and consumer organizations, such as the American Academy of Family Physicians, the American Academy of Pediatrics and Families USA.

The American Medical Association, which has emphasized the need to help the uninsured as part of the Cover the Uninsured coalition, has not signed on to the bill. But it praised Bingaman for shining "a spotlight on this important issue."

"The AMA is pleased that the HealthCARE Act expands tax credit options for the purchase of health insurance," said AMA President Yank D. Coble Jr., MD. "Individual tax credits put patients in control of health care decisions by allowing them to make important health care choices."

What's in the legislation

The tax credits, as proposed by the bill, would be available to people and families with incomes at or below 200% of the poverty level. Credits would be refundable and advanceable to ensure that people who owe no taxes could use them and that people have the money up front to pay their health insurance premiums.

Under the plan, tax credit recipients could buy into available plans or purchase coverage from state-based health insurance purchasing pools modeled on the Federal Employees Health Benefits Program. The pools could be organized either by their state or the federal government, if the state chooses not to take on that task.

The working poor also would be eligible for a tax credit if their share of employer-sponsored coverage was more than 5% of their income. Small business would be able to buy into the state purchasing pools under the plan.

States would be given new money to expand Medicaid to individuals with incomes at or below 100% of the poverty level, a switch from the often complicated means-testing system Medicaid programs now use.

But keeping with the theme of offering a carrot rather than a stick, states can come up with their own strategies for covering the target population, said Robert B. Doherty, ACP's senior vice president for government affairs and public policy.

States that go their own way still would be given the expanded level of federal matching funds promised by the bill, an acknowledgment that the best ideas for covering more people come from states, he said.

The Bingaman bill would boost Medicaid spending overall, but the implementation would cost states nothing. The measure would require the federal government to pick up the cost of covering more people in the states.

It is easier for the federal government to handle the extra costs than it is for the states, most of which are bound by law to balance their budgets every year, Doherty explained.

Back to top

 ADDITIONAL INFORMATION: