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Group presses Congress to extend health coverage

WASHINGTON—A prominent group of 16 national organizations challenged Congress on Thursday to cut quickly through gridlock and pass legislative proposals that would provide health coverage for more than 23 million uninsured Americans.

The top proposal by the Health Coverage Coalition for the Uninsured is a five-year, $45 billion effort dubbed the "Kids First Initiative." It calls for expanding funding and eligibility for the State Children's Health Insurance Program and a new tax credit to help struggling families buy job-based child coverage.

The group also recommended that Medicaid, the joint federal and state health program for the poor, should be modified to allow states to enroll poor single adults—with the federal government footing the bill.

To help pay for job-based private health coverage, the group proposed a separate tax credit for non-poor families earning up to three times the poverty limit—a maximum of $60,000 a year for a family of four.

These and other proposals, if implemented, would eliminate more than half of the nation's 47 million uninsured Americans, while providing coverage for about 98 percent of the nation's children, supporters said. About 18,000 Americans die each year from treatable and preventable illnesses because they lack health insurance, federal estimates show.

While the group had no cost estimates for their plans to expand coverage for adults, they agreed that to do nothing would cost more in the form of higher insurance premiums and taxpayer coverage of uncompensated care.

"These recommendations provide a realistic blueprint for immediate action by a bipartisan and caring Congress. We need more action and less debate," said Reed Tuckson, senior vice president at the United Health Foundation.

Drew Hammill, a spokesman for House Speaker Nancy Pelosi, said Pelosi backs the proposals' general thrust and "very much supports" the plans to expand the children's health insurance program, which is up for reauthorization.

But the recommendations, nevertheless, face a rocky road in Congress as lawmakers grapple with unsustainable Social Security and Medicare costs, a budget deficit, a costly war in Iraq and pay-as-you-go rules that require new budget expenditures to be offset by spending reductions or tax increases.

"Fiscal responsibility will always be a priority," Hammill added. "We'll put everything on the table and make the tough decisions."

The coalition proposals were crafted during more than two years of negotiations and are notable because they represent the collective voice of insurers, employers and pharmaceutical companies, plus physician and consumer groups—diverse health care players with a history of often-competing interests.

"We recognize we are strange bedfellows, but let this be clear, we are not interested in a one-night stand," said Ron Pollack, director of Families USA, a liberal patient advocacy group.

"Throughout this process, we challenged ourselves to reach consensus," Pollack said. "Now in turn we challenge America's policymakers in both houses of Congress, on both sides of the aisle, at both ends of Pennsylvania Avenue, to work together" to turn the recommendations into legislation.

But because the proposals do nothing to address rising health care costs, the changes would be short-lived if implemented, said Dr. Henry Simmons, president of the National Coalition on Health Care, which seeks solutions to health care inflation.

"Unless you couple reform proposals with some strong mechanism to contain rising costs, it is virtually impossible to sustain any mechanism of (expanded) coverage. It just can't be done," Simmons said.

Pollack said more than two-thirds of the nation's estimated 9 million uninsured children are in families earning more than twice the federal poverty line of $33,200 a year for a family of three. Many of these children are eligible for coverage under existing government health programs, but don't participate. The coalition proposal would automatically enroll low-income children in the children's health insurance program or Medicaid if they are found eligible for other anti-poverty programs like free school lunches and food stamps.

The coalition proposals got an unexpected jumpstart on Wednesday when a group of bipartisan lawmakers introduced House and Senate bills that adopt one of the coalition's proposals—providing grants for states to experiment with broad strategies to expand coverage. The bills were introduced by Sens. Jeff Bingaman, D-N.M., and George Voinovich, R-Ohio, and Reps. Tammy Baldwin, D-Wis., Tom Price, R-Ga., and John Tierney, D-Mass.

Sarah Berk, executive director of Health Care America, a conservative group that promotes consumer choice in health care, called the proposals "a good place to start."

"Although the devil is always in the details, these recommendations signal a step in the right direction, because they are not a one-size-fits-all approach to meeting the diverse health care needs of millions."

For more information about the Health Coverage Coalition for the Uninsured go to www.coalitionfortheuninsured.org.

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(c) 2007, McClatchy-Tribune Information Services.

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