Madam Speaker, it gives me great pleasure to introduce the American Health Insurance Act of 2007. I am joined by various cosponsors in supporting this common sense solution for the U.S. to finally achieve guaranteed, affordable, quality…
Madam Speaker, it gives me great pleasure to introduce the American Health Insurance Act of 2007. I am joined by various cosponsors in supporting this common sense solution for the U.S. to finally achieve guaranteed, affordable, quality health insurance coverage for all.
I have often spoken before this body about the great need to reform our health care system. For too long, we have been plagued with an inadequate patchwork that today leaves 45 million Americans uninsured. Our complex system requires us to spend more than any other nation on health care--30 percent on administration alone. Health care costs continue to rise, yet year after year hardworking families are faced with less access, more paperwork, and declining quality.
Our broken health system is a tremendous financial burden on our Nation's families and businesses alike. Half of all bankruptcies can be traced to medical bills. Eighty percent of people who file for bankruptcy because of medical bills have health insurance, but their benefits do not meet their needs. General Motors spends more on health care than on steel; Starbucks spends more on health insurance than on coffee.
These problems have only worsened over time. In years past, special interests have defeated attempts to reform the health system. Today, however, calls for health reform are being heard from unlikely voices and through strange partnerships. Wal-Mart joined SEIU, which has in turn joined AARP and the Business Roundtable, to call for government action. On March 6, the AFL-CIO abandoned its support of employer-based health care and began to push universal coverage through the expansion of Medicare. Even the for-profit hospitals have put forward a proposal.
This month, the New York Times reported that a majority of Americans would like the federal government to guarantee health insurance to every American--especially children. Nearly 80 percent think it is more important to provide universal access to health insurance than it is to extend the tax breaks of recent years. Sixty percent of Americans, including 62 percent of independents and 46 percent of Republicans, said they would be willing to pay more in taxes to guarantee access to all.
These various stakeholders may not agree on exactly which road we should travel. But they do finally all agree on our destination: guaranteed, affordable quality health coverage. The bill I am introducing today is the best way to get us there.
The AmeriCare Health Care Act of 2007 is a practical proposal to ensure that everyone has health coverage in our country. It builds on what works in today's health care system to provide simple, affordable, reliable health insurance. Under AmeriCare, people would continue to obtain health coverage through their employer--as most of us currently do--or they would be covered under the new AmeriCare system.
AmeriCare creates a new Title XXII in the Social Security Act. It uses Medicare's existing administrative infrastructure, but improves upon Medicare's benefits to address some of the current gaps in coverage, such as mental health parity, coverage for children, and family planning and pregnancy-related services for women. State Medicaid programs would remain responsible for long-term care, but AmeriCare would cover low-income children, women, and others who currently receive health care services under Medicaid.
AmeriCare is financed through premiums, paid 20 percent by individuals and families and 80 percent by employers. People with incomes under 200 percent of poverty would be fully subsidized, and premiums and cost-sharing would be phased in for those with incomes between 200 and 300 percent of poverty. General revenues and state funds would help to offset these costs.
AmeriCare limits out-of-pocket spending to ensure that no one spends a disproportionate share of their income on health care. Employers could continue to offer their own coverage, so long as it is at least as good as AmeriCare. Payment of premiums would be reconciled on our annual income tax forms.
Enacting AmeriCare would provide tremendous benefits to our Nation. A recent report by the Commonwealth Fund comparing several proposals by Members of Congress and the Bush Administration concluded that AmeriCare is the only health reform proposal that would provide for truly universal care, covering all of the nearly 45 million currently uninsured Americans.
Expanding insurance coverage to all will end the cost shifting that results from the high number of uninsured we have today. This could reduce premiums for job-based insurance by as much as $1,000 for family coverage, according to the Institute of Medicine.
Because AmeriCare builds on the highly efficient Medicare program, the Commonwealth Fund concluded that it would result in the greatest overall savings to the health system of all health reform plans they modeled. Medicare's per capita costs have grown at a slower rate than private health insurance or the Federal Employees Health Benefits Program. Using Medicare as a model will reduce costs for households, employers, state and local governments.
Our Nation is at a crossroads. Our legacy should be a future where our children are not saddled with debt, where they do not fear financial ruin due to an illness. Whether we build a healthy future for our children or not depends upon the decisions we make today. True compassion means offering real solutions, not empty promises.
Working together, applying common sense approaches that build on what works, we can ensure that no-one risks the loss of insurance coverage. All we need is the will to do it.
As we edge closer to our next discussion on health reform, we need to ask, is medical care a civic and social right like police and fire services, education, and environmental protection?
Or is health care ``you're on your own?''
I hope I can count on my colleagues and our endorsing organizations to advance a shared vision of higher quality, lower costs, and universal coverage through the adoption of AmeriCare.
Attached is a short summary of AmeriCare. More can be found on my website at http://www.house.gov/stark.
AmeriCare Health Care Act of 2007
Overview: The AmeriCare Health Care Act (``AmeriCare'') is
a practical proposal to ensure that everyone has health
coverage in our country. It builds on what works in today's
health care system to provide simple, affordable, reliable
health insurance. People would be covered under the new
AmeriCare system, modeled on Medicare, or they would continue
to obtain health coverage through their employer.
Using the administrative efficiencies within Medicare and
building on the existing coverage people receive through
their jobs today, we can create an affordable, efficient, and
stable universal health care system in America--and guarantee
access to medical innovation and the world's most advanced
providers and facilities.
Structure and Administration: Creates a new title in the
Social Security Act, ``AmeriCare.'' Provides universal health
care for all U.S. residents, with special eligibility for
children (under 24), pregnant women, and individuals with
limited incomes (<300% FPL). Sets out standards for
supplemental plans with a focus on consumer protection.
Requires the Secretary to negotiate discounts for
prescription drugs.
Benefits: Adults receive Medicare Part A and B benefits;
preventive services, substance abuse treatment, mental health
parity; and prescription drug coverage equivalent to the BC/
BS Standard Option in 2005. Children receive comprehensive
benefits and Early and Periodic Screening, Diagnostic, and
Treatment (EPSDT) coverage with no cost-sharing.
Cost Sharing: There is a $350 deductible for individuals,
$500 for families, and 20% coinsurance. Total spending
(premiums, deductibles, and co-insurance) is capped at out-
of-pocket maximum of $2,500 individual/$4,000 family, or 5
percent of income for beneficiaries with income between 200
percent-300 percent FPL and 7.5 percent of income for
beneficiaries with income between 300 percent-500 percent
FPL. There is no cost sharing for children, pregnant women,
low-income (below 200 percent FPL). Sliding scale subsidies
are in place for cost-sharing for individuals between 200
percent and 300 percent FPL.
Financing: At April 15 tax filing each year, individuals
either demonstrate equivalent coverage through their employer
or pay the AmeriCare premium based on cost of coverage and
class of enrollment (individual, couple, unmarried individual
with children, or married couple with children). Employers
may either pay 80 percent of the AmeriCare premium or provide
equivalent benefits through a group health plan (the
contribution for part-time workers is pro-rated). AmeriCare
does not affect contracts or collective bargaining agreements
in effect as of the date of enactment, and employers may
choose to provide additional benefits. Employers with fewer
than 100 employees have until January 1, 2012 to comply
(employees of small businesses would still only pay 20
percent of the premium).