A plan released last week by a broad coalition of healthcare groups to increase coverage of the uninsured was shot down by some former members of the effort as being too far-reaching and costly. As a result, those members don’t expect the plan to make much headway on an already crowded Capitol Hill agenda.
The coalition, called the Health Coverage Coalition for the Uninsured, had tried to toss out politics and partisanship with its two-part plan to cover at least half of the 46.6 million uninsured children and adults in the U.S. The coalition proposed to expand coverage through tax credits, state grants and a “one-stop shopping” system, where low-income families would be able to enroll children in the State Children’s Health Insurance Program and Medicaid at the same time they would apply for other public programs, such as food stamps. The coalition represents groups as diverse as Families USA, America’s Health Insurance Plans, Johnson & Johnson, the Catholic Health Association, and national medical and hospital associations.
Membership is what makes this coalition and its proposals unique, said Kevin Lofton, chairman of the American Hospital Association, in an interview. “Tell me at what time in history has there been a consensus position” released from all of these major healthcare organizations, he said. The fact that SCHIP is up for reauthorization this year is a key selling point for this proposal, which puts heavy emphasis on coverage for children, Lofton said.
But the group is missing some key members that originally were onboard when it was formed two years ago, including the National Association of Manufacturers, AFL-CIO and Service Employees International Union. The coalition’s proposal is a “firework that will shoot off and fizzle into the night,” considering that Congress won’t have a lot of money to spend on healthcare, said Neil Trautwein, vice president and employee benefits policy counsel for the National Retail Federation. “It’s just one more report added to 10 billion other reports” seeking solutions to the uninsured, he said.
Meanwhile, two congressional initiatives also were introduced last week, adding to the clamor for action on the uninsured issue. A bipartisan group of federal lawmakers said it would reintroduce legislation that allows states a freer rein to experiment with various healthcare strategies, much like Massachusetts and California have recently done. In the meantime, Sen. Ron Wyden (D-Ore.), a member of the Senate Finance Committee, introduced broad healthcare legislation that would guarantee coverage for almost all Americans by giving them the same health benefits enjoyed by members of Congress.
Other states took action last week, too. Pennsylvania Gov. Edward Rendell unveiled a long-anticipated plan to offer affordable healthcare coverage to small businesses and the uninsured through the private insurance market. Former Oregon Gov. John Kitzhaber introduced a state reform bill that would provide healthcare coverage to all Oregonians.
But the long-awaited national proposal from the Health Coverage Coalition is a lesson in how difficult it is to find a single, top-down solution.
This is not an approach that had assistance from the employer community, Trautwein said. NAM was one of several groups that pulled out of the coalition because its working proposals had become too “big and unwieldy,” he said.
Yet, some policymakers believe that consensus may be the only hand to play in the interest of reforming the healthcare system. At a news briefing introducing the bipartisan bill, Rep. Tammy Baldwin (D-Wis.) said that a bipartisan approach is needed because taken separately, “no single approach has enough support to become law.” The Health Coverage Coalition is still in conversation with employer groups, said Reed Tuckson, senior vice president of the United Health Foundation—a not-for-profit group funded by UnitedHealth Group—during the news briefing. “This is not the end of the process.”
