California Individual And Group Health Insurance Plans

The Los Angeles Times - By Ricardo Alonso-Zaldivar, Times Staff Writer -Nov. 13: Washington - Alarmed by the relentless erosion of employer-sponsored medical benefits, the health insurance industry today unveiled a proposal to extend coverage to more than 46 million uninsured persons.Combining solutions favored by Democrats with some that Republicans have backed, the proposal by America's Health Insurance Plans calls for providing coverage within three years to all uninsured children, currently numbering about 8 million, and within 10 years to virtually all adults.The trade group's plan would rely on a mixture of expanded federal and state programs and tax credits for workers and their families to purchase private health insurance."We should transcend the rigidly partisan political debates that have led only to stalemate," the group said in a statement accompanying the proposal. "Our nation needs a pragmatic approach driven by a broad understanding of the nature of the challenge and a strong commitment to the goal of covering all Americans."AHIP, as the group is known, represents almost 1,300 companies that provide health insurance policies, including traditional fee-for-service plans and managed-care plans such as health maintenance organizations.The insurance industry said its plan would cost the federal government $300 billion over 10 years, but the proposal lacked specifics on how it would be financed. Other estimates of providing coverage for all have been higher, $50 billion to $80 billion a year. By comparison, the federal government already spends more than $530 billion a year on two giant healthcare programs, Medicare for the elderly and Medicaid for the poor.The high cost of health insurance is the main reason for the rising number of uninsured Americans. The Kaiser Family Foundation's 2006 healthcare survey found an average cost of almost $11,500 a year for an employer-sponsored family plan. Employers, particularly smaller businesses, have been shedding coverage as costs have risen, and many individuals find it too costly to purchase a plan on their own.With Democrats taking over Congress next year, many policy leaders in the medical community, labor unions and even corporate boardrooms are hoping to revive a national debate that has been dormant since the collapse of the Clinton administration's plan more than 10 years ago."The election shows that Americans pay attention and they're willing to support change," Dr. Raymond J. Gibbons, president of the American Heart Assn., said Sunday at the group's annual scientific conference in Chicago. "There has been woefully little public discussion and, as a result, we haven't had the kind of national dialogue that's needed to find a solution."Polls show that Americans strongly back guaranteed coverage for all, but support melts away if it would mean significantly higher taxes - suggesting that the next debate on overhauling healthcare will focus on controlling costs.Already, U.S. employers say the high cost of health insurance for their workers puts them at a competitive disadvantage in the global marketplace. General Motors, for example, spent $5.3 billion for healthcare in 2005, more than it did on steel.The health insurance industry's proposal would build on the current system, a mix of federal and state programs, employer plans and individuals buying their own coverage.It calls for the expansion of the federally funded State Children's Health Insurance Program to cover all children in families with incomes up to twice the federal poverty level. That would help most children in low-income working families, since a family of four making up to $40,000 would be able to receive benefits.Similarly, the plan would expand Medicaid eligibility to adults earning up to the federal poverty level, which is $9,800 for a single person.The idea of using existing government programs to solve the problem of the uninsured has strong support among Democrats. But the insurance industry proposal also calls for two new tax breaks, a kind of approach traditionally favored by Republicans.A new $200-per-child tax credit, or up to $500 per family, would go to middle-class families who could show that their children were covered. The plan also calls for the creation of universal health accounts, a kind of tax break that would make it more affordable for the self-employed and those not covered by an employer to buy coverage on their own.