A change in leadership on Capitol Hill, a looming presidential campaign and a renewed sense of urgency about health care reform have brought together unusual alliances in Washington designed to achieve universal coverage.
In mid-January, 16 diverse national organizations—ranging from Families USA to the U.S. Chamber of Commerce—came together as the Health Coverage Coalition for the Uninsured and introduced recommendations for extending health care to 47 million uninsured Americans.
Earlier the same week, AARP, the Business Roundtable and the Service Employees International Union formed Divided We Fail, whose mission is to promote universal access to health care and long-term financial security.
Each group says it’s motivated by a desire to reduce health care costs, address social injustice, influence Congress and shape the presidential campaign agenda. Their leitmotif is similar: If we can work together, so can politicians.
“Peace is breaking out all over. Partnership is breaking out all over,” SEIU president Andy Stern says.
William Novelli, AARP’s chief executive, says, “People are open to change, and now is the opportunity to create it.”
The Health Coverage Coalition for the Uninsured is offering a two-part initiative. First, it would address the issue of the 9 million children who lack health coverage by making it easier for low-income families to enroll in a federal children’s insurance program. Families whose income is up to 300 percent of the federal poverty level would receive tax credits to buy insurance.
For uninsured adults, the group would expand Medicaid eligibility for low-income people and provide a refundable tax credit for higher earners.
On Capitol Hill, a steady stream of health care proposals is flowing. Sen. Ron Wyden, D-Oregon, introduced a bill that would enable private insurers to cover individuals directly. Companies would pay the government a health care contribution, rather than insure employees themselves.
Sen. Edward Kennedy, D-Massachusetts, favors achieving universal coverage by expanding Medicare. A bipartisan group has introduced a bill that would establish a commission to award grants to states to fund their own coverage ideas. And in his State of the Union address last week, President Bush proposed a standard health insurance tax deduction of up to $15,000. “Changing the tax code is a vital and necessary step to making health care affordable for more Americans,” he said.
As momentum builds, some in the business community worry that employers will end up footing the bill for additional coverage.
Corporate members of the health care coalition, however, assert that their plan would help low-income employees afford insurance, reducing billions of dollars of uncompensated costs that foster higher premiums.
“There are no mandates here,” says Robert Darretta, vice chairman of Johnson & Johnson. “We’re strong advocates of incentives. What we’re proposing is a helping hand.”
Expanding coverage could ultimately lower corporate health care bills because costs related to the uninsured are eventually borne by those who do provide coverage—companies.
“That needs to get addressed, no matter what [else] happens,” says Dan Ustian, president and CEO of Navistar International Corp.
How the debate unfolds depends on often elusive congressional political will. That’s why some members want to help more states follow the health care path blazed by
“Congress is not going to act in a major way to deal with this access problem in the next couple years,” says Sen. Jeff Bingaman, D-New Mexico.