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Achieving Universal Coverage with Private and Public Group Health Insurance |
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From The Commonwealth Fund: Despite a handful of statewide reform initiatives, the nation is losing ground on coverage and families are feeling the strain on their wallets and their health. The two core components of the "Building Blocks" framework---expanding Medicare and maintaining the current role of employer-sponsored insurance---are both in line with public opinion. As outlined by the authors, the plan would continue uninterrupted coverage for many insured people, while offering new options for small firms and individuals. Under Building Blocks, small businesses, the uninsured, and the self-employed could gain coverage through a new national insurance connector that would offer a choice of a Medicare-like option with enhanced benefits, called Medicare Extra, and private plans. The premiums for Medicare Extra would be community-rated for everyone under age 60, estimated at $259 per month for single premiums and $702 per month for families in 2008. To help finance the plan, employers would be required---under a "play or pay" mandate---to offer coverage or pay a payroll tax of 7 percent of earnings, up to $1.25 per hour. Low-income adults with incomes below 150 percent of the federal poverty level would be eligible for coverage through Medicaid and the State Children's Health Insurance Program (SCHIP), with premiums fully covered. "The estimated net effect on total national health spending is minor," say the authors, with an increase of less than 1 percent, or $15 billion dollars, in 2008. To learn more about the estimated impact of the Building Blocks framework, combined with health system reform initiatives, on coverage, access, and costs, read The Commonwealth Fund issue brief, The Building Blocks of Health Reform: Achieving Universal Coverage and Health System Savings.
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