The Commonwealth Fund has laid out a proposal to cover 44 million uninsured nationwide, improve rates and other costs, and save $1.6 trillion over 10 years.
Called the Building Blocks proposal, it would require everyone to carry health insurance and employers to provide benefits or pay 7% of payroll into a coverage pool. It would preserve the employer-based health insurance system but also create a national connector program to offer individuals and small businesses a choice of affordable private plans or a comparable plan through Medicare. Both Medicaid and the State Childrens Health Insurance Program would be expanded to cover all adults and children from families with incomes below 150% of the federal poverty level.
Total costs for the plan would be $15 billion in 2008, but would ultimately save $1.6 trillion over 10 years because of reforms, according to the Lewin Group. Provider reimbursement rates could improve under the system, as Medicaid rates would be on par with Medicare, and providers would see their bad debt and charity-care costs shrink dramatically, said Cathy Schoen, senior vice president of the Commonwealth Fund, which will present the proposal to Congress in June. A study about the proposal appears in the current issue of Health Affairs. -- by Rebecca Vesely