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Groups Accept Private Plan Role

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Health care reform efforts should keep the pillars of the current U.S. system – employer plans and public safety-net programs.

Representatives from insurance groups, provider groups, employer groups and other interest groups come to that conclusion in a new report issued by Health Reform Dialogue, Washington a coalition that is trying to help the groups reach a consensus on how to proceed.

The United States now has 46 million uninsured residents, and that number is greater “than the combined population of 24 states,” the coalition says in the report.

Congress should develop a universal health system that gives individuals eligible for Medicaid and the Children’s Health Insurance Program the option to use aid dollars to buy employer-sponsored coverage, the coalition says.

This should be allowed “so long as full Medicaid or CHIP wrap-around coverage is available,” the coalition says.

The coalition says any new system also should include:

- Advanceable, refundable tax credits or other subsidies on a sliding scale for individuals and families to buy adequate and affordable coverage, which should include effective preventive services.

- Subsidies for small businesses to provide health insurance for their employees.

- Assurances that a “fair and transparent marketplace” will be available for buying insurance regardless of individual’s health status, age, or other factors.

- Mandates that allow all individuals to buy or obtain quality, affordable health insurance and “ensure adequate payment to clinicians and providers by public programs to assure access to care.”

- Improvements in Medicaid and CHIP outreach and enrollment efforts.

- A nationwide floor for Medicaid eligibility. The floor should ensure that all adults with incomes under 100% of the federal poverty level are eligible for Medicaid.

- Federal funding for states that expand Medicaid.

- Standards for additional federal Medicaid funding during economic downturns.

- Restorations of legal immigrants’ eligibility for Medicaid coverage.

- A mechanism for studying ways to compare clinical effectiveness of treatments.

- Efforts to reform Medicare payment rules to encourage improvements in preventive care and care coordination.

- Funding for education, training, and loan forgiveness programs to increase the number of nurses and primary care doctors.

The list of groups involved in the Health Reform Dialogue includes, America’s Health Insurance Plans, Washington; the American Hospital Association, Washington; the Blue Cross and Blue Shield Association, Chicago; and Families USA, Washington.

AHIP President Karen Ignagni says the coalition report shows the high level of interest in reform efforts.

“The contributions from each stakeholder in the Health Reform Dialogue over the past 6 months have forged a consensus that the time for health care reform is now,” Ignagni says in a statement.

Scott Serota, the president of the Blues association, also is praising the coalition’s efforts.

“We understand what is at stake for our country,” Serota says. “We support an open dialogue about solutions that will put health care reform within reach.”